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目的 评价肝动脉节段性化学栓塞(TASCE)疗法治疗伴重度肝硬化(Child B级或C级、ICGR_15>10％)肝细胞癌患者的疗效及对肝功能的影响。方法 采用TASCE治疗21例(TASCE组),采用肝动脉化学栓塞(TACE)治疗28例(TACE组)作为对照。结果 TASCE组总缓解率为38.09％,中位生存期为9.8个月,累计生存率:半年为58.38％,1年为33.33％,2年为9.52％TACE组总缓解率为7.14％(P<0.05),中位生存期为4.4个月(P<0.01)和累计生存率半年为21.43％(P<0.05),1年为3.57％(P<0.05),2年为0。肝功能损害加重发生率相比:TASCE组SB为33.33％,ALT为47.62％和AST为52.38％;TACE组分别为82.14％(P<0.01),89.29％(P<0.01)和85.71％(P<0.05)。结论 TASCE治疗伴重度肝硬化肝癌疗效好,副反应小,肝功能损害轻,是一值得推广应用的放射介入治疗手段。
Objective To evaluate the efficacy of hepatic artery segmental chemoembolization (TASCE) in the treatment of hepatocellular carcinoma with severe cirrhosis (Child B or C, ICGR_15>10%) and its effect on liver function. Methods Twenty-one patients (TASCE group) were treated with TASCE and 28 patients (TACE group) were treated with hepatic arterial chemoembolization (TACE). Results The total remission rate was 38.09% in the TASCE group, and the median survival time was 9.8 months. The cumulative survival rate was 58.38% in half year, 33.33% in one year, and 9.52% in two years. The total remission rate in TACE group was 7.14% (P< The median survival time was 4.4 months (P<0.01) and the cumulative survival rate was 21.43% (P<0.05) for six months, 3.57% (P<0.05) for one year, and 0 for two years. The incidence of hepatic impairment was compared: TASCE group had 33.33% SB, ALT 47.62% and AST 52.38%; TACE group had 82.14% (P<0.01), 89.29% (P<0.01) and 85.71% (P). <0.05). Conclusion TASCE is effective in the treatment of hepatocellular carcinoma with severe cirrhosis. It has a small side effect and mild liver function damage. It is a radiation intervention therapy method worthy of popularization and application.