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经右胸廓内动脉供血的肝细胞癌的化疗栓塞术

Chemoembolization for hepatocellular carcinoma fed by right internal thoracic artery.

作者信息

Shen Tao, Jia Zhongzhi, Huang Yuanquan, Li Shaoqin, Jiang Guomin, Cheng Lihua

机构信息

Department of Interventional Radiology, Wujin Hospital, Jiangsu University Department of Interventional Radiology, No. 2 People's Hospital of Changzhou, Nanjing Medical University Department of Interventional Radiology, The Third Hospital Affiliated to Soochow University Department of Ultrasound, No. 2 People's Hospital of Changzhou, Nanjing Medical University, Changzhou, China.

出版信息

Medicine (Baltimore). 2017 Nov;96(45):e8634. doi: 10.1097/MD.0000000000008634.

Abstract

The purpose of the study was to evaluate the value of transarterial chemoembolization (TACE) via right internal thoracic artery (RITA) for patients with unresectable hepatocellular carcinoma (HCC).From January 2000 to June 2016, a retrospective study was conducted of all patients with unresectable HCC who underwent TACE via RITA across 3 medical centers. The technical success, serum alpha-fetoprotein (AFP) level changes, major complications, disease control rate, and survival were evaluated and analyzed.During the study peroid, in all, 21 patients (men 21; mean age 57.3 ± 7.1 years) were included in this study. Of the 21 patients, all the tumors were located under the capsule of the liver and adjacent to the diaphragm with median tumor diameter of 8.2 cm in 20 patients, and the tumor was located at the surface of the liver due to incisional site metastasis in 1 remaining patient. Lesions fed by the RITA were demonstrated during initial TACE in 2 patients and during repeat TACE therapy in 19 patients. The technical success rate was 100%. The AFP response 1 month after treatment was complete (n = 4) and partial (n = 9) of 13 patients whose AFP was abnormal before the procedure, and the serum levels of AFP reduced significantly 1 month after treatment (1240.1 ± 347.1 vs 175.2 ± 71.8; P < .01). No major complications occurred. The disease control rate was 100% at 3 months after treatment. The median overall survival from the time of TACE therapy via the RITAs was 18.2 months, and 1-year survival after TACE therapy via the RITAs was 76.2%.Chemoembolization via the RITA can improve the therapeutic efficacy of TACE and reduce the presence of residual HCC.

摘要

本研究的目的是评估经右胸廓内动脉(RITA)行经动脉化疗栓塞术(TACE)对不可切除肝细胞癌(HCC)患者的价值。2000年1月至2016年6月,对3个医疗中心所有经RITA行TACE的不可切除HCC患者进行了一项回顾性研究。评估并分析了技术成功率、血清甲胎蛋白(AFP)水平变化、主要并发症、疾病控制率和生存率。在研究期间,本研究共纳入21例患者(均为男性;平均年龄57.3±7.1岁)。21例患者中,所有肿瘤均位于肝包膜下且邻近膈肌,20例患者肿瘤中位直径为8.2 cm,1例其余患者因手术部位转移肿瘤位于肝表面。2例患者在初次TACE期间显示由RITA供血的病灶,19例患者在重复TACE治疗期间显示。技术成功率为100%。术前AFP异常的13例患者中,治疗后1个月AFP反应完全缓解(n = 4)和部分缓解(n = 9),治疗后1个月血清AFP水平显著降低(1240.1±347.1 vs 175.2±71.8;P < 0.01)。未发生主要并发症。治疗后3个月疾病控制率为100%。经RITA行TACE治疗后的中位总生存期为18.2个月,经RITA行TACE治疗后1年生存率为76.2%。经RITA化疗栓塞可提高TACE的治疗效果并减少残留HCC的存在。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0770/5690792/5b9da6627fe9/medi-96-e8634-g002.jpg

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