Yuen Man Fung, Chan Annie On-On, Wong Benjamin Chun-Yu, Hui Chee Kin, Ooi Gaik Cheng, Tso Wai Kuen, Yuan He Jun, Wong Danny Ka-Ho, Lai Ching Lung
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
Am J Gastroenterol. 2003 May;98(5):1181-5. doi: 10.1111/j.1572-0241.2003.07404.x.
The efficacy of transarterial chemoembolization (TACE) in prolongation of survival is controversial. We conducted a comparative study to determine whether TACE treatment had any survival benefit for patients with unresectable hepatocellular carcinoma (HCC) and with relatively preserved liver function.
In all, 96 patients with unresectable HCC of Okuda stage I or II and Child-Pugh grade A or B were recruited. A total of 80 patients (group 1) who received TACE were compared to 16 patients (group 2) who were treated conservatively.
The median survival time of group 1 patients was significantly longer than that of group 2 patients (31.2 vs 14.1 months respectively, p = 0.0126). The cumulative survival rates at 6 months, 1 yr, 2 yr, 3 yr, and 4 yr of group 1 compared to group 2 were as follows: 93.8% versus 62.5% (p = 0.002); 86.3% versus 62.5% (p = 0.023); 78.8% versus 50% (p = 0.017); 57.5% versus 50% (p = ns); and 51.3% versus 43.8% (p = ns), respectively. Tumor response was observed in 28% of patients receiving TACE. Patients with higher pretreatment albumin levels, lower pretreatment alpha-fetoprotein levels, and Okuda stage I disease were associated with a favorable response to TACE.
TACE treatment improved survival in patients with unresectable HCC in the early stages and with relatively preserved liver function.
经动脉化疗栓塞术（TACE）在延长生存期方面的疗效存在争议。我们进行了一项对比研究，以确定TACE治疗对无法切除的肝细胞癌（HCC）且肝功能相对保留的患者是否具有生存获益。
总共招募了96例Okuda I期或II期、Child-Pugh A级或B级的无法切除的HCC患者。将总共80例接受TACE治疗的患者（第1组）与16例接受保守治疗的患者（第2组）进行比较。
第1组患者的中位生存时间显著长于第2组患者（分别为31.2个月和14.1个月，p = 0.0126）。第1组与第2组在6个月、1年、2年、3年和4年时的累积生存率如下：93.8%对62.5%（p = 0.002）；86.3%对62.5%（p = 0.023）；78.8%对50%（p = 0.017）；57.5%对50%（p = 无显著性差异）；以及51.3%对43.8%（p = 无显著性差异）。在接受TACE治疗的患者中，28%观察到肿瘤反应。术前白蛋白水平较高、术前甲胎蛋白水平较低以及Okuda I期疾病的患者对TACE反应良好。
TACE治疗改善了早期无法切除的HCC且肝功能相对保留患者的生存期。
