肝癌根治性切除/消融术后辅助碘油 131I 治疗。
Adjuvant lipiodol I-131 after curative resection/ablation of hepatocellular carcinoma.
机构信息
University of New South Wales, Department of Surgery, St. George Hospital, Sydney, New South Wales, Australia.
出版信息
HPB (Oxford). 2008;10(6):388-95. doi: 10.1080/13651820802074449.
AIM
A total of 329 patients with hepatocellular carcinoma have been treated at our unit since 1990. Following the randomized controlled trial in Hong Kong by Lau et al. in 1999, patients have been offered adjuvant lipiodol I-131. The aim of this study was to determine the effectiveness of adjuvant lipiodol I-131, following potentially curative surgery with resection and/or ablation, on overall and disease-free survival rates.
MATERIAL AND METHODS
The prospectively updated hepatocellular carcinoma database was analysed retrospectively. A total of 34 patients were identified to have received adjuvant lipiodol I-131 post-curative treatment with surgical resection and/or ablation. Patient demographics, clinical, surgical, pathology, and survival data were collected and analysed.
RESULTS
Three patients received ablation alone, 24 resection, and 7 resection and ablation. Of the 34 patients treated, there were 2 possible cases of treatment-related fatality (pneumonitis and liver failure). Potential prognostic factors studied for effect on survival included age, gender, serum AFP concentration, Child-Pugh score, cirrhosis, tumor size, portal vein tumor thrombus, tumor rupture, and vascular and margin involvement. The median follow-up duration was 23.3 months. The overall median survival was 40.1 months, while the overall survival rates at 1, 2, 3, and 4 years were 87.1%, 71.7%, 60.7%, and 49.6%, respectively. Median duration to recurrence was 22.3 months.
CONCLUSION
Administration of adjuvant lipiodol I-131 is associated with good overall survival.
目的
自 1990 年以来，我们科室共治疗了 329 例肝细胞癌患者。1999 年，香港刘教授进行了随机对照试验后，为患者提供了辅助性碘油 I-131 治疗。本研究旨在确定辅助性碘油 I-131 治疗切除和/或消融后潜在治愈性手术的总体生存率和无病生存率的有效性。
材料与方法
回顾性分析前瞻性更新的肝细胞癌数据库。共确定 34 例患者接受了根治性手术切除和/或消融术后辅助碘油 I-131 治疗。收集并分析患者的人口统计学、临床、手术、病理和生存数据。
结果
3 例患者单独接受消融治疗，24 例患者接受切除治疗，7 例患者接受切除和消融联合治疗。34 例接受治疗的患者中，有 2 例可能与治疗相关的死亡（肺炎和肝功能衰竭）。研究了对生存有影响的潜在预后因素，包括年龄、性别、血清 AFP 浓度、Child-Pugh 评分、肝硬化、肿瘤大小、门静脉癌栓、肿瘤破裂以及血管和边缘侵犯。中位随访时间为 23.3 个月。总中位生存时间为 40.1 个月，1、2、3 和 4 年的总生存率分别为 87.1%、71.7%、60.7%和 49.6%。中位复发时间为 22.3 个月。
结论
辅助性碘油 I-131 治疗与良好的总体生存率相关。
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