Chung J W, Park J H, Han J K, Choi B I, Kim T K, Han M C
Department of Radiology, Seoul National University College of Medicine, Korea.
J Vasc Interv Radiol. 1998 May-Jun;9(3):495-500. doi: 10.1016/s1051-0443(98)70306-9.
To evaluate the efficacy and safety of transcatheter oily chemoembolization therapy (TOCE) via the inferior phrenic artery (IPA) in hepatocellular carcinoma (HCC).
Fifty patients with HCC underwent a total of 82 procedures of TOCE of the IPA, as well as of the hepatic artery. In 16 patients, additional extrahepatic collaterals were depicted and were also embolized in 10 patients. TOCE was performed with an emulsion of iodized oil and doxorubicin hydrochloride, and gelatin sponge particle embolization was added in 32 patients.
Initial response showed complete or partial remission of the tumor in 31 patients. The cumulative survival rates after combined TOCE of the hepatic artery, IPA, and other extrahepatic arteries were 89% (6 months), 78% (1 year), 46% (2 year), and 30% (3 year), when calculated from the time of IPA chemoembolization. Liver abscess and empyema developed in one case of combined IPA and multiple intercostal artery chemoembolization. There were no serious complications after IPA chemoembolization alone.
TOCE of the IPA has a potential therapeutic role as a safe adjunct to TOCE of the hepatic artery in the management of HCC supplied by the IPA.
评估经膈下动脉（IPA）行经导管油性化疗栓塞术（TOCE）治疗肝细胞癌（HCC）的疗效和安全性。
50例HCC患者共接受了82次IPA以及肝动脉的TOCE操作。16例患者显示有额外的肝外 collateral，其中10例也进行了栓塞。TOCE采用碘化油与盐酸阿霉素的乳剂进行，32例患者加用了明胶海绵颗粒栓塞。
初始反应显示31例患者肿瘤完全或部分缓解。从IPA化疗栓塞时算起，肝动脉、IPA及其他肝外动脉联合TOCE后的累积生存率分别为89%（6个月）、78%（1年）、46%（2年）和30%（3年）。1例IPA与多条肋间动脉联合化疗栓塞患者发生肝脓肿和脓胸。单纯IPA化疗栓塞后无严重并发症。
对于由IPA供血的HCC，IPA的TOCE作为肝动脉TOCE的一种安全辅助治疗手段具有潜在的治疗作用。
