化疗栓塞治疗原发性肝癌合并肝动静脉瘘的临床研究

发布时间：2018-05-01 16:02

  本文选题：肝肿瘤 + 动静脉瘘　； 参考：《放射学实践》2017年05期

【摘要】：目的:探讨化疗栓塞治疗原发性肝癌合并肝动静脉瘘(HAVS)的临床疗效及影响预后的因素。方法:67例不能手术切除的原发性肝癌合并HAVS患者行化疗栓塞治疗,观察HAVS栓塞效果及近期、远期疗效。应用Kaplan-Meier法、Log-rank检验进行患者的生存率分析,Cox回归模型进行多因素分析。结果:67例HAVS中肝动脉-门静脉瘘59例,肝动脉-肝静脉瘘8例;轻、中度动静脉瘘53例,重度动静脉瘘14例。HAVS完全栓塞44例(65.7%),轻、中度动静脉瘘的完全栓塞率(73.6%,39/53)高于重度动静脉瘘(35.7%,5/14),差异有统计学意义(χ~2=7.04,P=0.008)。67例患者中,完全缓解(CR)2例,部分缓解(PR)29例,疾病稳定(SD)30例,疾病进展(PD)6例,总有效率为46.7%(31/67)。67例患者1年生存率为49.3%,中位生存期为11.0个月。单因素分析结果显示肿瘤大小(8cm/≥8cm)、血管瘤栓(有/无)、术前AFP水平(400/≥400ng/mL)、碘油沉积类型(Ⅰ+Ⅱ/Ⅲ)、瘘口栓塞效果(瘘消失/未消失)的生存率差异有统计学意义(P0.05),Cox模型多因素分析显示肿瘤大小、碘油沉积类型是生存率的独立预后因素。结论:化疗栓塞治疗原发性肝癌合并HAVS有效,肿瘤大小、碘油沉积类型是独立的预后因素。
[Abstract]:Objective: to investigate the clinical efficacy and prognostic factors of chemoembolization in the treatment of hepatocellular carcinoma with hepatic arteriovenous fistula. Methods 67 unresectable patients with primary liver cancer combined with HAVS were treated with chemoembolization. The effect of HAVS embolization and the short-term and long-term results were observed. The survival rate of patients was analyzed by Kaplan-Meier 's Log-rank test and multivariate analysis by Cox regression model. Results among 67 cases of HAVS, 59 cases were hepatic arterial-portal vein fistula, 8 cases were hepatic arterio-hepatic vein fistula, 53 cases were mild and moderate arteriovenous fistula, 14 cases were severe arteriovenous fistula. The complete embolization rate of moderate arteriovenous fistula was 73.6% (39 / 53) higher than that of severe arteriovenous fistula (35 / 14). The difference was statistically significant (蠂 ~ (2 / 2) 7.04% P ~ (0.008). Among 67 patients, there were 2 cases of complete remission of CRT, 29 cases of partial remission of PRN, 30 cases of stable SDD, 6 cases of PDD, and 6 cases of disease progression. The total effective rate was 46.7%. The 1 year survival rate was 49.3% in 67 patients with a median survival time of 11.0 months. Univariate analysis showed that the survival rate of tumor size was 8cm / 鈮，

本文编号：1830067