[1]陈 嵩,吴志强,庄文权,等.经肝动脉栓塞术联合FOLFOX4方案持续动脉灌注化疗治疗肝细胞癌合并门静脉癌栓15例近期临床疗效评价[J].介入放射学杂志,2019,28(04):328-333.
 CHEN Song,WU Zhiqiang,ZHUANG Wenquan,et al.TAE combined with continuous hepatic artery infusion chemotherapy with FOLFOX4 scheme for HCC associated with PVTT: evaluation of its short- term efficacy in 15 patients[J].journal interventional radiology,2019,28(04):328-333.
点击复制

经肝动脉栓塞术联合FOLFOX4方案持续动脉灌注化疗治疗肝细胞癌合并门静脉癌栓15例近期临床疗效评价()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
28
期数:
2019年04期
页码:
328-333
栏目:
肿瘤介入
出版日期:
2019-04-25

文章信息/Info

Title:
TAE combined with continuous hepatic artery infusion chemotherapy with FOLFOX4 scheme for HCC associated with PVTT: evaluation of its short- term efficacy in 15 patients
作者:
陈 嵩 吴志强 庄文权 郭文波 李健齐
Author(s):
CHEN Song WU Zhiqiang ZHUANG Wenquan GUO Wenbo LI Jianqi.
Department of Interventional Radiology, First Affiliated Hospital of Sun Yat- Sen University, Guangzhou, Guangdong Province 510080, China
关键词:
【关键词】 肝细胞癌 门静脉癌栓 肝动脉栓塞术 FOLFOX4 持续动脉灌注化疗
文献标志码:
A
摘要:
【摘要】 目的 探讨肝动脉栓塞术(TAE)联合奥沙利铂+5- FU化疗(FOLFOX4)方案持续动脉灌注化疗治疗肝细胞癌(HCC)合并门静脉癌栓(PVTT)的近期临床疗效。方法 回顾性收集2015年1月至2017年6月15例行TAE联合FOLFOX4持续动脉灌注化疗治疗HCC合并PVTT患者,作为研究组,按照配对原则收集同时期15例行肝动脉化疗栓塞术(TACE)治疗HCC合并PVTT患者,作为对照组,对两组患者进行随访,随访频率为每月复查1次,最长随访周期为12个月,分析对比两组患者首次治疗后第3、6和12个月的生存率;对比两组患者PVTT的客观反应率(ORR)及疾病控制率(DCR)、HCC的ORR及DCR。结果 两组患者均成功完成治疗,术后均未发生严重并发症。研究组在12个月内的生存率高于对照组(P<0.05,Log- rank检验), 第3、6和12个月研究组患者存活率均高于对照组(100%,73.3%,46.7%比73.3%,33.3%,13.3%;P<0.05);研究组PVTT 的ORR及DCR均明显高于对照组(46.7%和 80.0%比13.3%和40%;P<0.05),HCC的ORR和DCR均稍高于对照组(26.7%和60.0%比13.3%和40%;P>0.05)。结论FOLFOX4方案TAE持续动脉灌注化疗治疗HCC合并PVTT安全可行,近期临床疗效优于TACE治疗,为HCC合并PVTT患者提供了一种新的安全有效治疗途径。

参考文献/References:

[1] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66: 115- 132.
[2] Forner A, Reig ME, De Lope CR, et al. Current strategy for staging and treatment: the BCLC update and future prospects[J]. Semin Liver Dis, 2010, 30: 61- 74.
[3] Cheng S, Chen M, Cai J, et al. Chinese expert consensus on multidisciplinary diagnosis and treatment of hepatocellular carcinoma with portal vein tumor thrombus: 2016 edition[J]. Oncotarget, 2017, 8: 8867- 8876.
[4] Zhang ZM, Lai EC, Zhang C, et al. The strategies for treating primary hepatocellular carcinoma with portal vein tumor thrombus[J]. Int J Surg, 2015, 20: 8- 16.
[5] Pawarode A, Voravud N, Sriuranpong V, et al. Natural history of untreated primary hepatocellular carcinoma: a retrospective study of 157 patients[J]. Am J Clin Oncol, 1998, 21: 386- 391.
[6] Peng BG, He Q, Li JP, et al. Adjuvant transcatheter arterial chemoembolization improves efficacy of hepatectomy for patients with hepatocellular carcinoma and portal vein tumor thrombus[J]. Am J Surg, 2009, 198: 313- 318.
[7] Schwarz RE, Abou- Alfa GK, Geschwind JF, et al. Nonoperative therapies for combined modality treatment of hepatocellular cancer: expect consensus statement[J]. HPB(Oxford), 2010, 12: 313- 320.
[8] 孙世蒙, 郭应兴, 雷振武, 等. TACE治疗原发性肝癌伴门静脉癌栓研究进展[J]. 介入放射学杂志, 2017, 26: 668- 671.
[9] 秦叔逵, 曹梦苒, 钱 军, 等. 奥沙利铂为主的FOLFOX方案治疗晚期原发性肝癌[J]. 临床肿瘤学杂志, 2005, 10: 58- 60.
[10] Lyu N, Kong Y, Mu L, et al. Hepatic arterial infusion of oxaliplatin plus fluorouracil/leucovorin vs. sorafenib for advanced hepatocellular carcinoma[J]. J Hepatol, 2018, 69: 60- 69.
[11] 杨柳青, 秦叔逵, 赵宁莉, 等. FOLFOX 4方案治疗中晚期原发性肝癌的临床研究[J]. 临床肿瘤学杂志, 2013, 18: 108- 113.
[12] Ikeda M, Shimizu S, Sato T, et al. Sorafenib plus hepatic arterial infusion chemotherapy with cisplatin vs. sorafenib for advanced hepatocellular carcinoma: randomized phase Ⅱ trial[J].Ann Oncol, 2016, 27: 2090- 2096.
[13] Zuo MX, Huang JH. The history of interventional therapy for liver cancer in China[J]. J Intervent Med, 2018, 1: 70- 76.
[14] 中华人民共和国卫生计生委. 原发性肝癌诊疗规范(2017年版)[J]. 传染病信息, 2017, 33: 111- 127.
[15] Lencioni R, Llovet JR. Assessment for hepatocellular carcinoma[J]. Semin Liver Dis, 2010, 30: 52- 60.
[16] Liu C, Xing W, Si T, et al. Efficacy and safety of apatinib combined with transarterial chemoembolization for hepatocellular carcinoma with portal venous tumor thrombus: a retrospective study[J]. Oncotarget, 2017, 8: 100734- 100745.
[17] Basch E, Reeve BB, Mitchell SA, et al. Development of the National Cancer Institute’s patient- reported outcomes version of the common terminology criteria for adverse events(PRO- CTCAE)[J]. J Natl Cancer Inst, 2014, 106: pii:dju244.
[18] Wilhelm S, Carter C, Lynch M, et al. Discovery and development of sorafenib: a multikinase inhibitor for treating cancer[J]. Nat Rev Drug Discov, 2006, 5: 835- 844.
[19] Bruix J, Sherman M, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update[J]. Hepatology, 2011, 53: 1020- 1022.
[20] Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma[J]. N Engl J Med, 2008, 359: 378- 390.
[21] Cheng AL, Kang YK, Chen Z, et al. Efficacy and safety of sorafenib in patients in the Asia- Pacific region with advanced hepatocellular carcinoma: a phase Ⅲ randomised, double- blind, placebo- controlled trial[J]. Lancet Oncol, 2009, 10: 25- 34.
[22] Iyer R, Fetterly G, Lugade A, et al. Sorafenib: a clinical and pharmacologic review[J]. Expert Opin Pharmacother, 2010, 11: 1943- 1955.
[23] Matsui O, Miyayama S, Sanada J, et al. Interventional oncology: new options for interstitial treatments and intravascular approaches: superselective TACE using iodized oil for HCC: rationale, technique and outcome[J]. J Hepatobiliary Pancreat Sci, 2010, 17: 407- 409.
[24] Yoon HJ, Kim JH, Kim KA, et al. Transcatheter arterial chemo- lipiodol infusion for unresectable hepatocellular carcinoma in 96 high- risk patients[J]. Clin Radiol, 2010, 65: 271- 277.
[25] Kim JH, Yoon HK, Kim SY, et al. Transcatheter arterial chemoembolization vs. chemoinfusion for unresectable hepato- cellular carcinoma in patients with major portal vein thrombosis[J]. Aliment Pharmacol Ther, 2009, 29: 1291- 1298.
[26] Kuroda M, Kobayashi Y, Urawa N, et al. Hepatic arterial infusion of 5- fluorouracil in combination with subcutaneous interferon- alpha for advanced hepatocellular carcinoma[J]. Hepato- gastroenterology, 2007, 54: 518- 521.

相似文献/References:

[1]姚雪松,李 槐.不可手术切除的肝细胞癌的疗效评价标准——改良RECIST标准更可靠[J].介入放射学杂志,2012,(03):177.
 . Therapeutic evaluation criterion of inoperable hepatocellular carcinomas: modified RECIST as a more reliable standard[J].journal interventional radiology,2012,(04):177.
[2].关于召开“全国肝癌介入治疗研讨会”的通知[J].介入放射学杂志,1995,(04):200.
[3]梁茂全,苏洪英. 肝癌化疗栓塞前后甲胎蛋白变化模式的临床意义[J].介入放射学杂志,2012,(04):333.
 .The transformation pattern of serum аfetoprotein after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma: its clinical significance [J].journal interventional radiology,2012,(04):333.
[4]孙 磊,施海彬,刘 圣,等.肝细胞癌肝动脉门静脉分流形成的相关因素分析[J].介入放射学杂志,2012,(03):206.
 ,,et al.The factors related to the formation of arterioportal shunting in patients with hepatocellular carcinomas [J].journal interventional radiology,2012,(04):206.
[5]沈海洋,刘瑞宝,刘 岩,等. 肝右叶前、后段原发性肝癌TACE后VEGF及CD34的表达水平 ;[J].介入放射学杂志,2012,(06):469.
 SHEN Hai- yang,LIU Rui- bao,LIU Yan,et al. The expression levels of vascular endothelial growth factor and CD34 in residual cancerous tissues of primary hepatocellular carcinoma located at anterior and posterior segments of right lobe liver after TACE[J].journal interventional radiology,2012,(04):469.
[6]李晓峰,钱国军,张 磊,等. 微波高功率条件下消融原发性肝癌的初步研究[J].介入放射学杂志,2011,(12):974.
 LI Xiao-feng,QIAN Guo-jun,ZHANG Lei,et al.Microwave ablation with high output power for the treatment of hepatocellular carcinoma: a preliminary study[J].journal interventional radiology,2011,(04):974.
[7]张   磊,陆骊工,李   勇,等.门静脉支架联合肝动脉化疗栓塞治疗肝癌伴门静脉癌栓的临床研究[J].介入放射学杂志,2011,(12):968.
 ZHANG Lei,LU Li-gong,LI Yong,et al.Portal vein stent placement combined with TACE for the treatment of hepatocellular carcinoma associated with tumor thrombus in portal vein[J].journal interventional radiology,2011,(04):968.
[8]彭辽河,胡晓燕,李 杰,等. 18F-FDG PET/CT显像在肝细胞癌TACE术后残留或复发病灶检出中的应用价值[J].介入放射学杂志,2012,(08):636.
 PENG Liao- he,HU Xiao- yan,LI Jie,et al. Clinical application of 18F- FDG PET/CT imaging in detecting residual lesions or recurrence foci of hepatocellular carcinoma after TACE treatment[J].journal interventional radiology,2012,(04):636.
[9]陆小华,朱小庆,茅国新.肝细胞癌相关单核苷酸多态性的研究进展[J].介入放射学杂志,2013,(06):520.
 LU Xiao? hua,ZHU Xiao? qing,MAO Guo? xin.. Hepatocellular carcinoma?蛳 related single nucleotide polymorphisms: recent advances in research[J].journal interventional radiology,2013,(04):520.
[10]李海伟,刘 静,李 森.125I粒子植入与伽玛刀治疗门脉癌栓的疗效对比[J].介入放射学杂志,2014,(08):702.
 LI Hai wei,LIU Jing,LI Sen..125Iodine seed implantation and gamma knife for the treatment of portal vein tumor thrombosis in hepatocellular carcinoma: comparison of therapeutic efficacy[J].journal interventional radiology,2014,(04):702.
[11]黄文薮,蔡明岳,曾昭吝,等.TACE联合125I放射性粒子植入治疗肝细胞癌门静脉癌栓[J].介入放射学杂志,2015,(06):488.
 HUANG Wen- sou,CAI Ming- yue,ZENG Zhao- lin,et al.Transarterial chemoembolization combined with CT- guided 125I seed implantation for the treatment of hepatocellular carcinoma associated with portal vein tumor thrombus[J].journal interventional radiology,2015,(04):488.
[12]王万胜,王 晨,沈 健,等.复合125I粒子植入技术联合TACE治疗肝癌合并门静脉癌栓[J].介入放射学杂志,2021,30(07):680.
 WANG Wansheng,WANG Chen,SHEN Jian,et al.Complex 125I seed implantation combined with transcatheter arterial chemoembolization for hepatocellular carcinoma complicated by portal vein tumor thrombus[J].journal interventional radiology,2021,30(04):680.
[13]刘 琦,张 颖,张精文,等.HAIC联合靶向和免疫治疗晚期肝癌伴门脉主干癌栓的研究[J].介入放射学杂志,2024,33(07):738.
 LIU Qi,ZHANG Ying,ZHANG Jingwen,et al.HAIC combined with targeted therapy and immunotherapy for advanced liver cancer complicated by main portal vein tumor thrombus: a clinical study[J].journal interventional radiology,2024,33(04):738.

备注/Memo

备注/Memo:
(收稿日期:2018-09-03)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2019-04-09