摘要
目的评价中晚期肝内胆管细胞癌(ICC)介入治疗效果及分析影响疗效的因素。方法回顾性分析2007年9月至2014年12月经病理诊断为肝内胆管细胞癌77例患者的临床资料。其中,51例行介入治疗,包括TACE及TACE联合射频消融(RFA)或^(125)I粒子植入术(归为介入组),26例行全身静脉化疗(化疗组)。统计分析ICC介入治疗患者的总生存期、肿瘤客观反应率及影响介入疗效的相关因素,同时观察介入治疗后的不良反应和并发症。结果介入组6、12和18个月生存率分别为70.6%、50.5%和35.4%,中位生存期为12.1个月(95%CI 8.43~15.77);肿瘤客观缓解率及疾病控制率分别为29.4%、70.6%。化疗组6、12和18个月年生存率分别为46.2%、7.7%和0,中位生存期为5.5个月(95%CI 3.38~7.61)。单因素分析显示介入治疗组患者中位生存期显著高于化疗组(P<0.05)。对影响介入组患者预后多因素分析显示,血清CA125水平、TNM分期及是否有外科根治术史是影响这类患者预后的独立因素。介入治疗的不良反应主要为骨髓抑制、栓塞后综合征及肝功能损害,均为Ⅰ、Ⅱ级。未出现与介入治疗相关的严重并发症。结论中晚期ICC行介入治疗是安全可行的,可以控制病情进展及延长患者生存期。
Objective To evaluate the curative effect of interventional therapy in treating advanced intrahepatic cholangiocarcinoma （ICC）, and to analyze the factors that may affect the prognosis. Methods The clinical data of 77 patients with pathologically proved advanced ICC, who were encountered at authors＇ hospital during the period from September 2007 to December 2014, were retrospectively analyzed. Of the 77 patients, interventional therapy was carried out in 51 （intervention group） and systemic venous chemotherapy was employed in 26 （chemotherapy group）. The interventional therapies included transarterial chemoembo- lization （TACE）, combination use of TACE and radiofrequency ablation （RFA）, and 12I seed implantation. The overall survival time, objective tumor response rates and the related factors affecting the prognosis of the intervention group were statistically analyzed, The procedure-related adverse events and complications were also reviewed. Results The 6-, 12-, and 18-month overall survival rates of the intervention group were 70.6%, 50.5% and 35.4% respectively, with the median survival time being 12.1 months （95%CI：8.43- 15.77） ; the objective response rate （ORR） and disease control rate （DCR） of the intervention group were 29.4% and 70.6% respectively. In the chemotherapy group, the 6-, 12-, and 18-month overall survival rates were 46.2%, 7.7% and 0% respectively, with the median survival time being 5.5 months （95%CI：3.38-7.61）. The univariate analysis revealed that the median survival time of the intervention group was significantly longer than that of the chemotherapy group （P〈0.05）. Multivariate analysis showed that the serum CA125 level, TNM stage and history of radical surgery were the independent factors that affected the prognosis ofthese patients. The main adverse effects of interventional treatment were mainly myelosuppression, post- embolization syndrome and liver function damage, and the extent of these damages was grade Ⅰ or grade Ⅱin all case
出处
《介入放射学杂志》
CSCD
北大核心
2016年第9期813-817,共5页
Journal of Interventional Radiology
基金
江苏省第四期"333工程"科研项目(BRA2013287)
江苏省"六大人才高峰"第九批资助项目(WS-052)
关键词
肝内胆管细胞癌
介入治疗
肝动脉化疗栓塞术
全身静脉化疗
intrahepatic cholangiocarcinoma
interventional therapy
transarterial chemoembolization
systemic venous chemotherapy
