Therapeutic Effect of Transcatheter Arterial Chemoembolization in Young Patients with Unresectable Hepatocellular Carcinoma

經導管動脈化學栓塞術治療年輕人無法切除之肝細胞癌療效之評估

姜仁惠(Jen-Huey Chiang) ； 李潤川(Rheun-Chuan Lee) ； 曾修山(Tsiu-Shan Tseng) ； 邱怡友(Yi-You Chiou) ； 黃振義(Jen-I Hwang) ； 周宜宏(Yi-Hong Chou) ； 陳行素(Shin-Su Chen) ； 鄧木火(Michael Mu-Hou Teng) ； 吳肇卿(Jaw-Chin Wu) ； 雷永耀(Wing-Yiu Lui) ； 張政彥(Ch)

《中華放射線醫學雜誌》 26卷4期 (2001/08) Pp. 159-164

摘要

肝細胞癌為世界性最常見的惡性腫瘤中之一種。依照地域的差異，其好發年齡稍有不同，年長者和年輕者其致癌因素也可能稍有不同。本研究之目的在於評估經導管動脈化學栓塞術治療年輕之肝細胞癌病人之療效如何。
自1983年至1998年，有42位40歲以下患肝細胞癌之年輕病人，在本院接受動脈化學栓塞術，其中三人得寡結節型、八人得多結節型、二十一人得單一巨大型、十人得浸潤型肝細胞癌。施行經導管動脈化學栓塞術時，先從肝動脈注射adriamycin和lipiodol混合液，然後再注入gelfoam把動脈堵住。我們對這組年輕病人做回覆式評估其療效，並做檢討。同期間內113位年齡61至69歲老年族接受動脈化學栓塞術之肝細胞癌病人，其存活率亦計算出來，以資比較。
年輕族組人，其6月、12月、24月、36月之存活率分別為71.01%，47.27%，23.76%，7.92%。中位存活時間15個月。年老組為77.88%，65.89%，49.27%，29.04%。中位存活時間25個月。由此可見動脈化學栓塞術對年輕病人療效不如老年組，對其存活助益不大。

關鍵字

肝臟 ； 腫瘤 ； 肝腫瘤 ； 診療放射學 ； 動脈 ； 治療性栓塞

並列摘要

Hepatocellular carcinoma is one of the most common malignant tumors in the world. The peak age of onset of hepatocellular carcinoma varies according to geographic barriers. Different hepatocarcinogenesis were found among population of young and elder age and, therefore, the prognosis might be different among them. The aim of this study is to evaluate the therapeutic efficacy of transcatheter arterial chemoembolization in young patients with unresectable hepatocellular carcinoma.
From 1983 to 1998, 42 patients younger than 40 years old with unresectable hepatocellular carcinoma underwent transcatheter arterial chemoembolization. Three patient had oligonodular type hepatocellular carcinoma, 8 had multiple nodular, 21 had massive solitary (14 of them had multiple daughter nodules) and 10 had infiltrative hepatocellular carcinoma. Transcatheter arterial chemoembolization was performed by transcatheter hepatic arterial infusion of adriamycin-lipiodol emulsion followed by delivery of gelatin sponge particles. We retrospectively review the clinical manifestations, tumor features and therapeutic efficacy of transcatheter arterial chemoembolization in young patients. In addition, 113 patients with hepatocellular cacinoma with their age ranged from 61 to 69 years old, and underwent transcatheter arterial chemoembolization during the same period were also reviewed for comparison.
The overall survival rates at 6, 12, 24 and 36 months periods were 70.01, 47.27, 23.76 and 7.92% for patients younger than 40 years old (median survival was 15 months) vs 77.88, 65.89, 49.27 and 29.04% for patients aged 61 to 69 years old (median survival was 25 months). Transcatheter arterial chemoembolization does not show as good survival benefit in young patient group as elderly patient group.

並列關鍵字

Liver neoplasm ； therapy ； Arteries ； therapeutic blockade