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经皮射频消融联合顺铂肝动脉灌注化疗治疗 JIS 评分 0/1 期早期肝细胞癌

Hepatic arterial infusion chemotherapy with cisplatin before radical local treatment of early hepatocellular carcinoma (JIS score 0/1) improves survival.

机构信息

Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan.

Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan.

出版信息

Ann Oncol. 2014 Jul;25(7):1379-1384. doi: 10.1093/annonc/mdu155. Epub 2014 Apr 15.

Abstract

BACKGROUND

It has not yet been determined whether hepatic arterial infusion (HAI) chemotherapy improves survival in patients with early hepatocellular carcinoma (HCC). We evaluated the effectiveness of HAI with high-concentration cisplatin (DDP-H) for the treatment of HCC by comparing outcomes between patients who received HAI with DDP-H before radical local treatment of early-stage HCC [Japan Integrated Staging (JIS) score 0/1] and patients who did not receive HAI chemotherapy.

PATIENTS AND METHODS

Survival was analyzed in 114 patients with early-stage HCC who underwent radical local treatment. The patients were divided into two groups: a HAI group (n = 79) who received DDP-H infusion into the whole liver via the proper hepatic artery, and a non-HAI group (n = 35) who did not receive HAI chemotherapy.

RESULTS

The cumulative survival rates at 1, 3, and 5 years were 77.4%, 69.2%, and 55.3% in the non-HAI group and 97.4%, 87.0%, and 84.4% in the HAI group, respectively. Survival time prolonged significantly in the HAI group compared with the non-HAI group (log-rank test: P = 0.023; generalized Wilcoxon test: P = 0.012) Multivariate analysis using the Cox proportional hazards model identified HAI with DDP-H as the most important factor affecting survival.

CONCLUSIONS

Whole-liver HAI with DDP-H before radical local treatment can improve the prognosis of patients with early-stage HCC.

摘要

背景

尚未确定肝动脉灌注(HAI)化疗是否能提高早期肝细胞癌(HCC)患者的生存率。我们通过比较接受高浓度顺铂(DDP-H)HAI 治疗的患者与未接受 HAI 化疗的患者的结果,评估了 DDP-H 用于早期 HCC [日本综合分期(JIS)评分 0/1]根治性局部治疗患者的疗效。

患者和方法

对 114 例接受根治性局部治疗的早期 HCC 患者进行生存分析。患者分为 HAI 组(n = 79)和非 HAI 组(n = 35),前者经肝固有动脉给予 DDP-H 全肝灌注,后者未接受 HAI 化疗。

结果

非 HAI 组和 HAI 组的 1、3 和 5 年累积生存率分别为 77.4%、69.2%和 55.3%和 97.4%、87.0%和 84.4%。HAI 组的生存时间明显长于非 HAI 组(对数秩检验:P = 0.023;广义 Wilcoxon 检验:P = 0.012)。使用 Cox 比例风险模型进行多因素分析,确定 DDP-H 的 HAI 是影响生存的最重要因素。

结论

根治性局部治疗前进行 DDP-H 全肝 HAI 可改善早期 HCC 患者的预后。

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