Chen Xiao-Ming, Luo Peng-Fei, Lin Hua-Huan, Zhou Ze-Jian, Shao Pei-Jian, Fu Li, Li Wei-Ke
Department of Oncology Intervention, Cancer Center,Guangdong Provincial People's Hospital, Guangzhou, Guangdong, 510080, P.R.China.
Ai Zheng. 2004 Jul;23(7):829-32.
BACKGROUND & OBJECTIVE: Both transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) are the most important and popular procedures of interventional treatment for hepatocellular carcinoma (HCC). Although the improvement of the short-term efficacy of the combination of TACE and PEI has been proved, the long-term efficacy is seldom reported so far. The purpose of this study was to evaluate the long-term efficacy of the combination of TACE and PEI for treatment of HCC.
Six hundred and seventy-five patients with HCC from 2 cm to 15 cm in the greatest diameter (average 9.6 cm) were enrolled in this study. Among them, 179 were treated by a combination of TACE using the emulsion of lipiodol and anti-cancer drugs and PEI (TACE/PEI group) and 496 patients by TACE alone (TACE group). Ten patients in each group underwent resection after the final interventional treatment and the resected specimens were detected by histopathology method. The unresected patients had been followed up for 5-7 years and the 1-, 3-, 5 -, and 7-year survival rates were evaluated. The clinical data of the patients in two groups before intervention were comparable.
Pathological data of two groups showed that remarkable differences were found in the mean necrosis rates (100.0+/-0.0% vs 91.5+/-7.1%, P< 0.05) and the complete necrosis rates of tumors (100% vs 20%, P = 0.0007), while there were no statistical significances in the extent of shrinkage of tumors after treatment between two groups. The results of follow-up showed that the 1-, 3-, 5-, and 7-year survival rates were 80.5%, 58.6%, 29.6%, 16.5% in TACE-PEI group, and 68.5%, 27.8%, 7.2%, 5.2% in TACE group, respectively. Significant differences were found between two groups (P< 0.01).
The combination of TACE and PEI is a valuable remedy for HCC to prolong long-term survival rate.
经导管动脉化疗栓塞术（TACE）和经皮乙醇注射术（PEI）都是肝细胞癌（HCC）最重要且最常用的介入治疗方法。尽管已证实TACE与PEI联合应用可提高短期疗效，但目前关于其长期疗效的报道较少。本研究旨在评估TACE与PEI联合治疗HCC的长期疗效。
本研究纳入675例最大直径为2 cm至15 cm（平均9.6 cm）的HCC患者。其中，179例采用碘油与抗癌药物乳剂的TACE联合PEI治疗（TACE/PEI组），496例仅接受TACE治疗（TACE组）。每组10例患者在最后一次介入治疗后接受手术切除，切除标本采用组织病理学方法检测。未接受手术切除的患者进行了5至7年的随访，并评估了1年、3年、5年和7年生存率。两组患者干预前的临床资料具有可比性。
两组病理数据显示，平均坏死率（100.0±0.0%对91.5±7.1%，P<0.05）和肿瘤完全坏死率（100%对20%，P = 0.0007）存在显著差异，而两组治疗后肿瘤缩小程度无统计学意义。随访结果显示，TACE-PEI组的1年、3年、5年和7年生存率分别为80.5%、58.6%、29.6%、16.5%，TACE组分别为68.5%、27.8%、7.2%、5.2%。两组间差异有统计学意义（P<0.01）。
TACE与PEI联合应用是延长HCC患者长期生存率的有效治疗方法。
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