Yamashita Y, Takahashi M, Koga Y, Saito R, Nanakawa S, Hatanaka Y, Sato N, Nakashima K, Urata J, Yoshizumi K
Department of Radiology, Kumamoto University School of Medicine, Japan.
Acta Radiol. 1990 May;31(3):269-74.
From January 1986 to December 1988, 85 patients (55 men and 30 women, mean age 59 years) with metastatic liver tumors were treated with hepatic artery embolization (TAE) or infusion (HAI). Sixty-eight patients with successful catheterization were treated with TAE using iodized oil (Lipiodol) mixed with anticancer agent (ACA). In 12 of 68 patients with hypervascular tumors gelatin sponge was added. Patients with unsuccessful catheterization were treated with hepatic artery infusion of ACA. Forty-three patients received oral chemotherapy following TAE or HAI. Overall, the 6-month, and 1- and 2-year survival rates were 69.5, 31.8 and 4.1 per cent, respectively (mean 233 days). A univariate analysis of prognostic factors showed that number of metastases, stage, treatment times and oral chemotherapy were all significant factors (p less than 0.05). Ascites, jaundice, percentage of hepatic replacement and treatment protocol also had some influence (p less than 0.1). Sex, age, primary site, elevation of tumor markers, other metastatic lesions, portal vein involvement and difference in anticancer agent had no prognostic significance. A multivariate analysis using Cox's proportional hazard model revealed that the number of treatments had the most important prognostic significance, followed by oral chemotherapy, stage and percentage of hepatic replacement.
1986年1月至1988年12月，85例转移性肝肿瘤患者（55例男性，30例女性，平均年龄59岁）接受了肝动脉栓塞（TAE）或灌注（HAI）治疗。68例插管成功的患者采用碘化油（Lipiodol）与抗癌剂（ACA）混合进行TAE治疗。68例富血管肿瘤患者中有12例加用了明胶海绵。插管不成功的患者接受了肝动脉ACA灌注治疗。43例患者在TAE或HAI后接受了口服化疗。总体而言，6个月、1年和2年生存率分别为69.5%、31.8%和4.1%（平均233天）。对预后因素的单因素分析表明，转移灶数量、分期、治疗次数和口服化疗均为显著因素（p<0.05）。腹水、黄疸、肝替代百分比和治疗方案也有一定影响（p<0.1）。性别、年龄、原发部位、肿瘤标志物升高、其他转移灶、门静脉受累情况以及抗癌剂差异无预后意义。使用Cox比例风险模型进行的多因素分析显示，治疗次数具有最重要的预后意义，其次是口服化疗、分期和肝替代百分比。
