肝癌伴下腔静脉癌栓行TACE联合下腔静脉放射性支架或裸支架治疗的对照研究

发布时间：2018-05-09 20:23

本文选题：~()I + 肝细胞肝癌　；参考：《介入放射学杂志》2017年07期

【摘要】：目的探讨TACE联合下腔静脉放射性支架植入治疗肝细胞肝癌伴下腔静脉癌栓的安全性及有效性。方法对61例肝细胞肝癌伴下腔静脉癌栓患者的资料行回顾性分析,放射性支架采用125I粒子条捆载裸支架的方法,共对33例患者采用此方法(A组),28例患者植入裸支架(B组)。采用倾向性评分匹配(propensity score matching)对原数据进行后随机化分析以减少选择性偏倚,对两组患者的生存期,症状缓解率及不良反应进行对照分析。结果两组患者术后不良反应发生率相仿,均采用内科对症处理。A组患者较B组显示更长的生存期优势,A组中位生存时间(203.0±28.1)d,B组(93.0±24.3)d(P=0.006),倾向性评分匹配后(24对)A组(200±31)d,B组(66.0±23)d(P=0.019),A组水肿缓解率97.0%,B组为96.4%,多因素分析显示放射性支架植入与肿瘤客观有效率为患者预后好的独立性影响因素。结论 TACE联合放射性支架植入对治疗肝细胞肝癌伴下腔静脉癌栓安全有效,可能延长患者生存时间。
[Abstract]:Objective to investigate the safety and efficacy of TACE combined with radioactive stent implantation in the treatment of hepatocellular carcinoma with inferior vena cava tumor thrombus. Methods the data of 61 patients with hepatocellular carcinoma associated with inferior vena cava tumor thrombus were retrospectively analyzed. Radioactive stents were strapped with 125i seed strips to carry bare stents, and 33 patients were treated with this method. 28 patients in group A were implanted with bare stents (group B). The tendency score matching propensity score matching was used to conduct postrandomization analysis of the original data to reduce the selective bias. The survival time, symptom remission rate and adverse reactions were compared between the two groups. Results the incidence of postoperative adverse reactions was similar between the two groups. The median survival time of group A was 203.0 卤28.1g / d group (93.0 卤24.3), and that of group A was 66.0 卤31d / d B group (66.0 卤23d / d). The relief rate of edema in group A was 96.44.Multivariate analysis showed that the remission rate of edema was 96.4in group A (66.0 卤23d P0. 019D) after the diopter score was matched in group A and group B (P < 0.05). The results showed that the remission rate of edema in group A was 96.44.Multivariate analysis showed that the remission rate of edema in group A was 97.0%, and that in group B was 96.4%. Projectile stent implantation and tumor effectiveness were independent factors for the prognosis of patients. Conclusion TACE combined with radioactive stent implantation is safe and effective in the treatment of hepatocellular carcinoma with inferior vena cava tumor thrombus, and may prolong the survival time of the patients.
【作者单位】：复旦大学附属中山医院介入科、上海市医学影像研究所;
【基金】：上海市卫生计生委2013年度先进适宜技术推广项目(2013SY060) 国家自然科学基金青年项目(81201170) 上海市卫生计生委科研项目(20124188)
【分类号】：R735.7

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