Eurvilaichit C, Kanjanapitak A
Department of Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2000 Sep;83(9):983-91.
From July 1989 to July 1999, 120 male and 30 female patients with hepatocellular carcinoma (HCC), whose ages ranged from 18 to 71 years, were treated by different modalities. The patients were divided into 3 groups according to treatment modalities: group 1 consisted of 35 cases treated by transarterial embolization (TAE) using gelatin sponge permeated with mitomycin-c 20 mg, group 2 - 100 cases treated by transcatheter oily chemoembolization (TOCE) using lipiodol 10 cc with mitomycin-c 20 mg together with gelatin sponge for hepatic embolization, and group 3 - 15 cases treated by TOCE followed by surgical wedge hepatic resection. The prognostic features following treatments were retrospectively analysed in relation to therapeutic modalities. The results revealed that TOCE was superior to TAE and that TOCE plus adjunct wedge hepatic resection was the best treatment modality with the best cumulative surgical rate (median survival 46.69 months). Analysis of the life-table methods of group 2 patients revealed that the stage of tumors and serum biochemistry on entry, both of which corresponded well with hepatic reserve function were statistically significant prognostic factors for treatment result and long-term outcomes. Further analysis of all the patients also revealed that tumor size and stage of tumors were significant prognostic factors for the treatment of hepatocellular carcinomas.
1989年7月至1999年7月，120例男性和30例女性肝细胞癌（HCC）患者接受了不同方式的治疗，年龄范围为18至71岁。根据治疗方式将患者分为3组：第1组由35例采用含20mg丝裂霉素C的明胶海绵经动脉栓塞（TAE）治疗的患者组成；第2组由100例采用10cc碘油与20mg丝裂霉素C联合明胶海绵进行肝动脉化疗栓塞（TOCE）治疗的患者组成；第3组由15例先接受TOCE然后行手术楔形肝切除的患者组成。对治疗后的预后特征与治疗方式进行了回顾性分析。结果显示，TOCE优于TAE，且TOCE联合辅助楔形肝切除是最佳治疗方式，累积手术率最高（中位生存期46.69个月）。对第2组患者生存表方法的分析显示，肿瘤分期和入院时的血清生化指标与肝储备功能密切相关，二者均为治疗结果和长期预后的统计学显著预后因素。对所有患者的进一步分析还显示，肿瘤大小和肿瘤分期是肝细胞癌治疗的显著预后因素。
