摘要
目的比较经导管肝动脉栓塞(TAE)和肝动脉灌注化疗栓塞(TACE)在原发性肝癌(PLC)介入治疗中的远期疗效。方法选取2004年1月—2011年12月河北医科大学第四医院收治的PLC患者258例,将患者按照采取的治疗方法分为TAE组(n=91)和TACE组(n=167)。在数字减影血管造影(DSA)下,TAE组行肿瘤供血动脉栓塞术,TACE组行肿瘤供血动脉灌注化疗栓塞术。以首次介入治疗为起点,以患者死亡或截至随访时间为终点,随访截止时间为2014-12-31。应用Kaplan-Meier法进行生存分析,Log-rank检验比较TAE组与TACE组生存率。结果两组Child-Pugh分级比较,差异有统计学意义(P<0.05)。TAE组1年、2年和3年的生存率分别为45.1%、24.2%、14.7%,中位生存时间为12.0个月;TACE组1年、2年和3年的生存率分别为53.3%、30.5%、20.4%,中位生存时间为14.6个月,两组生存率比较,差异无统计学意义(χ2=1.018,P=0.313)。当肿瘤直径>10 cm时,TAE组(n=17)1年、2年和3年的生存率分别为17.6%、5.9%、0,TACE组(n=18)分别为44.4%、33.3%、27.8%,两组生存率比较,差异有统计学意义(χ2=5.652,P=0.017)。结论 TAE与TACE是治疗中晚期PLC的有效方法,两者的远期疗效无差异,但当肿瘤直径>10 cm时,TACE的远期疗效优于TAE。
Objective To analyze the long - term efficacy of transarterial embolization（ TAE） and transarterial chemoembolization（TACE）in primary liver carcinoma（ PLC） interventional treatment. Methods We enrolled 258 PLC patients who were admitted into the Fourth Hospital of Hebei Medical University from January 2004 to December 2011,and assigned them into TAE group（n = 91）and TACE group（n = 167）according to treatment methods. TAE group underwent blood supply artery embolization by digital subtraction angiography（ DSA）,and TACE group underwent TACE. The first intervention treatment was taken as the starting point,and death and end of follow - up（until 2014 - 12 - 31）were taken as the end points. Kaplan - Meier method was used to conduct survival analysis,and Log - rank method was used to compare the survival rate between TAE group and TACE group. Results The two groups were not significantly different in Child - Pugh staging（P 〈0. 05）. 1 - year,2 - year,3 - year survival rates and median survival time were 45. 1% ,24. 2% ,14. 7% and 12. 0 months for TAE group and were 53. 3% ,30. 5% ,20. 4% and 14. 6 months for TACE group,and there were no significant differences in survival rates between the two groups（χ^2 = 1. 018,P = 0. 313）. In the case of tumor diameter 〉 10 cm,1 - year,2 - year, 3 - year survival rates were 17. 6% ,5. 9% and 0 for TAE group（n = 17）and 44. 4% ,33. 3% and 27. 8% for TACE group （n = 18）,and the two groups were significantly different in survival rate（χ^2 = 5. 652,P = 0. 017）. Conclusion TAE and TACE have become preferred effective methods for middle and late stage PLC,and there is no significant difference in long - term efficacy between the two treatment methods,while the long - term efficacy of TACE is superior to that of TAE in the case of tumor diameter 〉 10 cm.
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第11期1292-1296,共5页
Chinese General Practice
基金
河北省强势特色学科资助项目(冀教高[2005]52号)
关键词
肝肿瘤
肝动脉栓塞
肝动脉灌注化疗栓塞
疗效比较研究
Liver neoplasms
Transarterial embolization
Transcatheter arterial chemoembolization
Comparative effectiveness research
