Transcatheter Arterial Chemoembolization for Treatment of Small Hepatocellular Carcinoma: Comparison of Surgical and Supportive Treatments

經動脈化學栓塞法治療小型肝細胞癌：與外科及保守療法之比較

姜仁惠(Jen-Huey Chiang) ； 黃振義(Jen-I Hwang) ； 鄭慧正(Hui-Cheng Cheng) ； 李潤川(Rhuan-Chuan Lee) ； 曾修山(Hsiuo-Shan Tseng) ； 周宜宏(Yi-Hong Chou) ； 刁翠美(Chui-Mei Tiu) ； 吳肇卿(Jaw-Chin Wu) ； 雷永耀(Wing-Yiu Lui)

《中華放射線醫學雜誌》 20卷4期 (1995/12) Pp. 293-301

摘要

為確定經動脈化學栓塞法(TACE)治療小型肝細胞癌之療效，我們對139位曾接受TACE治療或外科治療或支持性保守療法的病人加以評估。其中44人接受TACE治療，病人之一年及五年存活率分別為90%和24%。臨床上無肝病症狀者之存活率比有症狀者佳，肝功能良好，血清阿發胎兒蛋白濃度較低者，預後也較好。70人接受手術切除腫瘤，其一年及五年之存活率為89%和40%。25人接受支持性保守治療，其中10人肝功能良好，其一年及五年之存活率為80%和10%。另15人肝功能顯然不良，其一年、二年及三年存活率分別為47%、24%和0%。三組病人相較可知，TACE治療小型肝癌細胞效果良好，但因病人多有肝硬化現象，維護良好肝臟功能與治療腫瘤同等重要，而多次TACE治療可能導致遲性肝功能衰退或衰竭。

關鍵字

肝腫瘤 ； 介入性治療 ； 動脈化學栓塞治療法

並列摘要

To study the usefulness of transcatheter arterial chemoembolization (TACE) for small hepatocellular carcinoma (HCC), 139 patients who were treated with TACE, surgery or supportive medicine were reviewed. Forty- four patients underwent TACE therapy. Their one-year and five-year survival rates were 95% and 24%, respectively. The survival values of patients who had neither clinical symptoms nor signs of liver disease, good liver function and lower serum aipha-fetoprotein (AFP) concentration were significantly higher than those with symptoms, poor liver function and high serum AFP. Seventy patients underwent partial hepatectomy with 89% and 40% one- and five-year survival rates,respectively Ten of the supportive treatment patients with good liver function had one- and five-year survival rates of 80% and 10%, respectively. The one, two- and three-year survival rates of the remaining 15 hepatic decompensation patients were 47%, 24% and 0%, respectively. Since in a majority of patients with small HCCs having an association with liver cirrhosis, preservation of good liver function for such patients is much important for their survival. TACE is effective in treatment of small HCCs over a relatively short period, however, delaying deterioration of liver function maybe an unexpected complication of multiple TACE therapy, especially in cases of lobar embolization.

並列關鍵字

arteries, chemotherapeutic embolization ； liver neoplasm ； liver neoplasm, interventional ； liver neoplasm, therapy