The efficacy and safety of postoperative adjuvant transarterial embolization and radiotherapy in hepatocellular carcinoma patients with portal vein tumor thrombus.
The efficacy and safety of postoperative adjuvant transarterial embolization and radiotherapy in hepatocellular carcinoma patients with portal vein tumor thrombus.
复制标题
DOI：
10.2147/ott.s104307
复制
发表时间：
2016
影响因子：
4
通讯作者：
Li LQ
中科院分区：
文献类型：
--
作者：
Bai T;Chen J;Xie ZB;Wu FX;Wang SD;Liu JJ;Li LQ
本研究旨在探讨肝细胞癌（HCC）门静脉癌栓（PVTT）患者术后辅助经动脉化疗栓塞（TACE）和放疗（RT）的安全性和有效性。 2009年至2010年，共有92名患有PVTT的HCC患者参与了这项回顾性研究。根据辅助治疗将患者分为三组（保守组，n=51；TACE组，n=31；RT组，n=10）。在我们的分析中，术后辅助 TACE（21.91±3.60 个月）或 RT（14.53±1.61 个月）患者的中位生存期显着长于仅接受肝切除术的患者（8.99±1.03 个月）。但辅助TACE与RT之间差异无显着性（P=0.716）。中位无病生存期也有类似的结果：保守组（6.51±1.44个月）、TACE组（13.98±3.38个月）和RT组（14.03±2.40个月）。治疗策略（风险比[HR]=0.411，P<0.001）和PVTT类型（HR=4.636，P<0.001）是总生存的独立预后因素。同样，无病生存（治疗策略，HR=0.423，P<0.001；PVTT型，HR=4.351，P<0.001）和复发（治疗策略，HR=0.459，P=0.030；PVTT型，HR=2.908，P=0.047）进行多因素分析时，危险因素相同。 PVTT I型患者的总生存期长于PVTT II型患者（中位生存期：18.43±2.88个月 vs 11.59±1.45个月，P=0.035）。术后辅助 TACE 和 RT 可能是合并 PVTT 的 HCC 患者的一种选择。
This study aims to find out the safety and efficiency of postoperative adjuvant transarterial chemoembolization (TACE) and radiotherapy (RT) in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT). From 2009 to 2010, a total of 92 HCC patients with PVTT were enrolled in this retrospective study. Patients were divided into three groups according to their adjuvant therapies (conservative group, n=51; TACE group, n=31; RT group, n=10). In our analysis, median survival in patients with postoperative adjuvant TACE (21.91±3.60 months) or RT (14.53±1.61 months) was significantly longer than patients with hepatectomy alone (8.99±1.03 months). But the difference between adjuvant TACE and RT was of no significance (P=0.716). Also a similar result could be observed in median disease-free survival: conservative group (6.51±1.44 months), TACE group (13.98±3.38 months), and RT group (14.03±2.40 months). Treatment strategies (hazard ratio [HR] =0.411, P<0.001) and PVTT type (HR =4.636, P<0.001) were the independent prognostic factors for overall survival. Similarly, the risk factors were the same when multivariate analysis was conducted in disease-free survival (treatment strategies, HR =0.423, P<0.001; PVTT type, HR =4.351, P<0.001) and recurrence (treatment strategies, HR =0.459, P=0.030; PVTT type, HR =2.908, P=0.047). Patients with PVTT type I had longer overall survival than patients with PVTT type II (median survival: 18.43±2.88 months vs 11.59±1.45 months, P=0.035). Postoperative adjuvant TACE and RT may be a choice for HCC patients with PVTT.