Dumortier J, Chapuis F, Borson O, Davril B, Scoazec J-Y, Poncet G, Henry L, Boillot O, Mion F, Berger F, Partensky C, Paliard P, Valette P-J
Department of Digestive Diseases, Edouard Herriot Hospital, Hospitals of Lyon, Lyon, France.
Dig Liver Dis. 2006 Feb;38(2):125-33. doi: 10.1016/j.dld.2005.10.025. Epub 2006 Jan 4.
The majority of patients with hepatocellular carcinoma are not eligible for surgical radical treatment (resection or liver transplantation) and lipiodol chemoembolisation is an efficient alternative procedure in this indication.
To identify prognostic factors in patients treated with lipiodol chemoembolisation.
During 10 years, 89 consecutive patients with unresectable hepatocellular carcinoma underwent lipiodol chemoembolisation as a single treatment. There were 80 males and 9 females, with a median age of 65 years. Treatment consisted of one to six courses of hepatic intra-arterial lipiodol with doxorubicine and gelatin sponge.
The median survival was 13 months with a 13.6% survival rate at 4 years. Univariate analysis showed that serum levels of albumin, bilirubin, alkaline phosphatase and alpha-fetoprotein, Child's class, tumour type, tumour size and intensity of lipiodol capture after the first course of lipiodol chemoembolisation were significant prognostic factors of survival. In the multivariate analysis, four parameters remained associated with a significantly better outcome: Child's class A, largest lesion<5 cm, uninodular tumour and intense lipiodol capture.
While lipiodol chemoembolisation is associated with good results only in some patients, in the absence of lipiodol capture, it should be ruled out.
大多数肝细胞癌患者不符合手术根治性治疗（切除或肝移植）的条件，而碘油化疗栓塞术是该适应症下一种有效的替代治疗方法。
确定接受碘油化疗栓塞术治疗患者的预后因素。
在10年期间，89例连续的无法切除的肝细胞癌患者接受了碘油化疗栓塞术作为单一治疗。其中男性80例，女性9例，中位年龄65岁。治疗包括一至六个疗程的肝动脉内注射碘油联合阿霉素和明胶海绵。
中位生存期为13个月，4年生存率为13.6%。单因素分析显示，血清白蛋白、胆红素、碱性磷酸酶和甲胎蛋白水平、Child分级、肿瘤类型、肿瘤大小以及第一个疗程碘油化疗栓塞术后碘油摄取强度是生存的重要预后因素。多因素分析中，有四个参数与显著更好的预后相关：Child A级、最大病灶<5 cm、单结节肿瘤和碘油摄取强烈。
虽然碘油化疗栓塞术仅在部分患者中疗效良好，但在无碘油摄取的情况下，应排除该治疗方法。
