摘要
目的探讨125I粒子植入治疗原发性肝癌的临床疗效及预后影响因素。方法回顾性纳入国内5家医院2011年12月至2021年1月接受125I粒子植入治疗的102例原发性肝癌患者(男86例、女16例,中位年龄61岁)临床资料,分析局部无进展生存(LPFS)和总生存(OS)及预后影响因素。采用Kaplan-Meier法绘制生存曲线,计算LPFS率和OS率,采用log-rank检验、Cox比例风险回归模型探讨生存的影响因素。结果截至2021年4月,中位随访38个月,局部控制率为96.1%(98/102),1、3、5年LPFS率为61.3%、25.5%、12.7%,1、3、5年OS率为73.9%、39.1%、22.6%。75例患者粒子植入治疗后进展,其中42例肝内复发转移,55例死亡。多因素分析结果显示,近期疗效完全缓解(CR)[风险比(HR)=0.34,95%CI:0.20~0.58]为LPFS的保护性因素;近期疗效CR(HR=0.25,95%CI:0.13~0.47)为肝癌粒子植入治疗后OS的保护性因素,巴塞罗那临床肝癌(BCLC)分期C期(HR=2.33,95%CI:1.27~4.27)、治疗后肝内进展及肝外转移(HR=3.18,95%CI:1.28~7.86;HR=3.23,95%CI:1.27~8.21)为OS的危险因素。125I粒子植入过程及治疗后未见严重并发症。结论 125I粒子植入治疗原发性肝癌安全有效,BCLC分期、近期疗效及粒子植入治疗后进展为影响生存时间的预后因素。
Objective To evaluate the efficacy and prognostic factors of 125I seeds implantation for primary hepatocellular carcinoma.Methods From December 2011 to January 2021,102 primary hepatocellular carcinoma patients(86 males,16 females;median age 61 years)who underwent 125I seeds implantation from 5 hospitals in China were enrolled in this retrospective study.Local progression-free survival(LPFS),overall survival(OS)and the prognostic factors were analyzed.Kaplan-Meier method was used to draw the distribution curve of survival time,and LPFS rate and OS rate were calculated.Log-rank test and Cox regression were used to analyze the influencing factors of survival.Results The median follow-up time was 38 months until April 2021.The local control rate was 96.1%(98/102).The 1-,3-and 5-year LPFS rate were 61.3%,25.5%and 12.7%,and the 1-,3-and 5-year OS rate were 73.9%,39.1%and 22.6%,respectively.There were 75 patients with progressive disease,including 42 patients with intrahepatic recurrence and metastasis after seed implantation,and 55 patients died.Multivariate analyses showed that short-term efficacy complete response(CR)(hazard ratio(HR)=0.34,95%CI:0.20-0.58)was protective factor related to LPFS;short-term efficacy CR(HR=0.25,95%CI:0.13-0.47)was the protective factors related to OS;Barcelona clinic liver cancer(BCLC)C stage(HR=2.33,95%CI:1.27-4.27),intrahepatic progression and extrahepatic metastasis(HR=3.18,95%CI:1.28-7.86;HR=3.23,95%CI:1.27-8.21)were independent risk factors related to OS.No sever adverse effects were observed.Conclusions 125I seeds implantation is safe and effective for the treatment of primary hepatocellular carcinoma.BCLC stage,short-term efficacy and post-implantation progression are independent factors related to survival time.
作者
袁倩倩
胡苗苗
马艳丽
宋钰卿
何闯
黄学全
杨崇双
祝贺
王喆
张开贤
王俊杰
张久严
刘斌
Yuan Qianqian;Hu Miaomiao;Ma Yanli;Song Yuqing;He Chuang;Huang Xuequan;Yang Chongshuang;Zhu He;Wang Zhe;Zhang Kaixian;Wang Junjie;Zhang Jiuyan;Liu Bin(Department of Oncology,Tengzhou Central People′s Hospital,Tengzhou 277500,China;Department of Oncology,the Worker′s Hospital of Chengde Iron and Steel Limited Company,Chengde 067102,China;Department of Nuclear Medicine,Southwest Hospital,Army Medical University,Chongqing 400038,China;Department of Oncology,Shanxi Hospital of Integrated Traditional and Western Medicine,Taiyuan 030013,China;Department of Oncology,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China;Department of Radiation Oncology,Peking University Third Hospital,Beijing 100191,China;Department of Clinical Pharmacy,Tengzhou Central People′s Hospital,Tengzhou 277500,China;Department of Surgery,Tengzhou Central People′s Hospital,Tengzhou 277500,China)
出处
《中华核医学与分子影像杂志》
CAS
CSCD
北大核心
2022年第11期666-671,共6页
Chinese Journal of Nuclear Medicine and Molecular Imaging
