TACE联合125I粒子植入治疗原发性肝癌伴门静脉癌栓的预后分析
Transcatheter Arterial Chemoembolization Combined with Iodine-125 Seed Implantation for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus:Prognostic Analysis
印于 1杨俊 1倪才方1
作者信息
- 1. 苏州大学附属第一医院介入科,江苏 苏州 215006
- 折叠
摘要
目的 评估经动脉化疗栓塞(TACE)联合125I粒子植入治疗原发性肝癌伴门静脉癌栓(PVTT)预后,探索其相关预后因素.方法 回顾性分析在2016年1月—2019年12月行TACE联合125I粒子植入治疗的原发性肝癌伴PVTT患者,建立病例资料数据库,对相关因素采用Kaplan-Meier检验进行生存率的单因素分析,Cox风险回归模型多因素分析得出独立预后因子.结果 该研究共纳入57 例患者,6、12、18和24 个月的生存率分别为71.9%、45.6%、23.4%和17.5%,中位生存时间为9.5 个月.多因素分析得出4个独立影响因素:肿瘤最大径(HR 2.487,95%CI:1.242～4.978)、PVTT分型(HR 1.886,95%CI:1.177～3.019)、动门脉瘘(HR 5.165,95%CI:2.130～12.525)、PVTT反应率(HR 2.087,95%CI:1.503～2.899),4个因素对生存期的影响差异均有统计学意义(P＜0.05).结论 影响TACE联合125I粒子植入治疗原发性肝癌伴PVTT患者的独立预后因子为肿瘤最大径、PVTT分型、动门脉瘘及PVTT反应率.
Abstract
Objective To evaluate the prognosis of transcatheter arterial chemoembolization(TACE)combined with 125I seed implantation in the treatment of primary hepatocellular carcinoma with portal vein tumor thrombus(PVTT),and explore the related prognostic factors.Methods A retrospective analysis was performed on patients with primary hepatocellular carcinoma with PVTT who received TACE combined with 125I seed implantation from January 2016 to December 2019.A case data database was established,and Kaplan-Meier test was used for univariate analysis of survival rate for related factors.Multivariate analysis of Cox risk regression model revealed independent prognostic factors.Results A total of 57 patients were enrolled in this study,and the survival rates at 6,12,18 and 24 months were 71.9%,45.6%,23.4%and 17.5%,respectively,with a median survival time of 9.5 months.Multivariate analysis showed that there were four independent influencing factors:maximum tumor size(HR 2.487,95%CI:1.242-4.978),PVTT type(HR 1.886,95%CI:1.177-3.019),arterial-portal-shunt(HR 5.165,95%CI:2.130-12.525),PVTT response rate(HR 2.087,95%CI:1.503-2.899),and the above four factors on survival were statistically significant(P＜0.05).Conclusion The independent prognostic factors influencing TACE combined with 125I seed implantation in patients with primary hepatocellular carcinoma with PVTT were tumor size,PVTT typing,arterial-portal-shunt and PVTT response rate.
关键词
原发性肝癌/门静脉癌栓/肝动脉化疗栓塞/125I粒子/预后分析Key words
primary hepatocellular carcinoma/portal vein tumor thrombus/transcatheter arterial chemoembolization/125I seed/prognostic analysis引用本文复制引用
基金项目
北京医学奖励基金会(YXJL-2020-0972-0419)
出版年
2024
NETL
NSTL
万方数据