Safety and Efficacy of Irradiation Stent Placement for Malignant Portal Vein Thrombus Combined with Transarterial Chemoembolization for Hepatocellular Carcinoma: A Single-Center Experience
Safety and Efficacy of Irradiation Stent Placement for Malignant Portal Vein Thrombus Combined with Transarterial Chemoembolization for Hepatocellular Carcinoma: A Single-Center Experience
复制标题
放射支架置入治疗恶性门静脉血栓联合经动脉化疗栓塞治疗肝细胞癌的安全性和有效性：单中心经验
DOI：
10.1016/j.jvir.2017.02.014
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发表时间：
2017-06-01
影响因子：
2.9
通讯作者：
Teng, Gao-Jun
中科院分区：
文献类型：
--
作者：
Lu, Jian;Guo, Jin-He;Teng, Gao-Jun
目的：评价放射性门静脉支架治疗肝细胞癌门静脉癌栓(PVTT)的可行性、安全性和初步疗效。材料与方法：自2012年10月至2015年9月，40例肝细胞癌门静脉癌栓患者中，25例(平均年龄55.5岁)在一家医院接受了放射性门静脉支架的治疗。肝功能分级为Child-Pugh A级15例(60%)，B级10例(40%)。东部合作肿瘤组表现状态评分为0分3例(12%)，1例13例(52%)，2例9例(36%)。支架置入后行肝动脉化疗栓塞术。根据技术成功率、并发症、支架通畅率和总存活率来衡量结果：结果：技术成功率92.0%(23/25)。根据不良事件通用术语标准，未观察到3级或更高级别的并发症。中位支架通畅期为8.0个月(0.6~30.0个月)。支架置入后7~955天，共进行65个周期的动脉化疗栓塞术，平均每个患者2.8个周期。中位生存期为12.5个月(0.6~35.7个月)。结论：放射性门静脉支架置入安全可行，可延长门静脉通畅率。它是门静脉闭塞再通和近距离放射治疗相结合的一种有前景的技术。
Purpose: To assess feasibility; safety, and preliminary efficacy of an irradiation portal vein stent for portal vein tumor thrombosis (PVTT) hi patients with hepatocellular carcinoma (HCC):Materials and Methods: Between October 2012 and September 2015, 25 Of 40 patients (mean age of 55.5 y) with PVTT caused by HCC were recruited for treatffierit with an irradiation portal vein stent (self-expandable gent loaded with iodine-125 seeds) at a Single hospital. Liver frinction was classified as Child-Pugh class A in 15 patients (60%) and class B in 10 patients (40%). The Eastern Cooperative Oncology Group performance status score was 0 in 3 Patients (12%); 1 in 13 patients (52%), and 2 in 9 patients (36%). Transarterial chemoembolization was performed after stent placement. Outcomes were measured in terms of technical success, complications, stent patency, and overall survival:Results: The technical success, rate was 92.0% (23/25). No complications grade 3 or higher according to Common Terminology Criteria for Adverse Events were observed. Median stent patency period was 8.0 months (range, 0.6-30.0 months). Between 7 and 955 days after stent placement, 65 cycles of transarteriaI chemoembolization were performed with a mean of 2.8 cycles per patient. Median survival was 12.5 months (range, 0.6-35.7 months).Conclusions: Placement of an irradiation portal vein stent appears feasible and safe and may prolong the patency of the portal vein. It is a promising technique for combining recanalization of an occluded portal vein and brachytherapy.