医药学论文-肝癌伴门静脉癌栓的治疗进展.txt

õñã (hepatocellular carcinomaHCC)İ(portal vein tumor thrombiPVTT)PVTT¡ 1 HCC1ãChild?Pugh AB Fukuda21948.5%Konishi3PVTT PVTT¼棺õõB 4ô1295.4%47.0%20.0%ô¸á 2 ñ(drug delivery systemDDS) ¸±ùýõDDS52鷢 ñ DDS(HAI)(PVI)ô(DDS)()PVTTAndo6õ5?FU48HCCPVTTø(hepatic arterial infusion chemotherapyHAIC)ý14PVTT34PVTT419(=48%)123545%31%25%11%232531.6(8.376.9)5.4(1.929.0)(P0.001)(P=0.021)71384飺14411964(transcatheter arterial chemoembolizationTACE)ù(hepatic artery infusionHAI)()ù(portal vein infusionPVI)13.4£0.512353.7%37.6%30.7%14.0%3.5£7.1£10.3£3(P0.05)滯 3 (transcatheter arterial chemoembolizationTACE) PVTTTACE ëPVTTã8TACE Chung9TACE110PVTTùTACE311230%18%10ãTACE11Katsumori12HCCPVTT0.51267%44%22% TACEõTACE13TACE 4 90%PVTTPVTTPVTTPVTT¶ÿûþ 1438PVTTB¾68.4%76.3%1373.7%18.4%PVTT15472TACE黼6122436µ98.9%84.3%46.7%4.2%(P0.01)黼(P0.05) 5 (percutaneous ethanol injectionPEI) PVTTPEI16PEI590% TACETACEPEI PEIB½PEI 17ô18PVTT38.9%İ44.4%16.7%PEIChan181PVTT18ºYantamoto1950HCCPVTTóTACE 12B100%/90%12392.5%57.5%20% PEIPVTTüõã÷ 6 PVTTPVTT¸÷ÿ20Yamakado2021PVTT÷25.37.4mmHg22.46.6mmHg(P0.01)õ112.4¡15TACE0.51264.2%29.2%29.2% 7 ( ultrasonic disruption)õ仯DNA21-22230100%23.2 cmH2O14.3 cmH2Oô1.8 h8.0 h鷢24Walker?256 羵塢鷢S½G2+M绯23 8 TACE25÷26114060 Gy5(45%)12£155%嶨TACEPVTTõ Yamada27PVTT(60 Gy)TACE 19HCCPVTT57.9%1240.6%10.2%7.0£PVTTHuang2841HCCPVTTTACEPVT10£17£8£4£PVTT(P=0.001) HCCPVTTPVTT¸PVTT30PVTT3520%029PVTTµãPVTT 1 . J. 200526(3)273-275.2 Fukuda S Okuda K Imamura M et al. Surgical resection combined with chemotherapy for advanced hepatocellular carcinoma with tumor thrombusreport of 19 casesJ. Surgery2002131(3)300-310.3 Konishi M Ryn M Kinoshita T et al. Surgical treatment of hepatocellular carcinoma with direct removal of the tumor thrombus in the main portal reinJ. Hepatogastroenterology200148(41)1421.4 £. (25)J. 199414(1)18-19.5 . (180)J. 199810(4)178-180.6 Ando E Tanaka M Yamashita F et al. Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosisanalysis of 48 casesJ. Cancer200295(3)588-595.7 . J. 200341(11)801-804.8 Ralls PW. Color Doppler sonography of the hepatic artery and portal venous systemJ. AJR1990155(3)517-520.9 Chung JW Park JH Han JK et al. Hepatocellular carcinoma and portal vein invasion results of treatment with transcatheter oily chemoembolizationJ. Am J Radiol1995165(2)315-321.10 Trinchet JC Ganne?Carrie N Beangrand MI. Intraarterial chemoembolization in patients with hepatocellular carcinoma1J. Hepatogastroenterology199845(suppl 3)1242.11 Terayama N Miyayama S Tatsu H et al. Subsegmental transcatheter arterial embolization for hepatocellular carcinoma in the caudate lobeJ. J Vasc Interv Radiol19989(3)501-508.12 Katsumori T Fujita M Satoh O et al. Effective segmental chemoembolization of advanced hepatocellular carcinoma with tumor thrombus in the portal veinJ. Cardiovasc Intervent Radiol199518(4)217-221.13 Asaki Y Imaoka S Kasugai H et al. A new approach to chemoembolization therapy for hepatoma using ethiodized oilcisplatinand gelatin spongeJ. Cancer198760(6)1194-1203.14 . J. 19997(1)13-14.15 . J. 200322(8)693-697.16 . 268J. 200120(3)1471.17 . J. 200110(2)81-83.18 Chan Mk Kwork PC Chan SC et al. PEI as a possible curative treatment for malignant portal vein thrombosis in hepatocellular carcinomaJ. Cardiovasc Intervent Radiol199922(4)3261.19 Yantamoto K Masuzawa H Kato M et al. Evaluation of combined therapy with chemoembolization and ethanol injection for advanced hepatocellular carcinomaJ. Semin Oncol199724(suppl 6)50-55.20 Yamakado K Tanaka N Nakatsuka A et al. Clinical efficacy of portal vein stent placement in patients with hepatocellular carcinoma invading the main portal veinJ. J Hepatol199930(4)660-668.21 Liebeskind D Bases R Koenigsberg M et al. Morphological changes in the surface characteristics of cultured cells after exposure to diagnostic ultrasoundJ. Radiology1981138(2)419-423.22 Sacks PG Miller MW Sutherland RM. Response of multicell spheroids to 1?MHz ultrasonic irradiationcavitation?related damageJ. Radiation Res198393(3)545-559.23 . J. 200015(1)24-26.24 ³. J. 20055(2)119-121.25 Lin DY Lin SM Liaw YF. Non?surgical treatment of hepatocellular carcinomaJ. J Gastroenterol Hepatol199712(9-10)s319-328.26 壬. J.2003184251256.27 Yamada K Izaki K Sugimoto K et al. Prospective trial of combined transcatheter arterial chemoembolization and three? dimensional conformal radiotherapy for portal vein tumor thrombus in patients with unresectable hepatocellular carcinomaJ. Int J Radiat Oncol Biol Phys200357(1)113-119.28 Huang CJ Lian SL Chen SC et al. External beam radiation therapy for inoperable hepatocellular carcinoma with portal vein thrombosisJ. Kaohsiung J MedSci200117(12)610-614.29 Fan J Wu ZQ. Multimodality treatment in hepatocellular carcinoma patients with tumor thrombi in portal veinJ. Gastroentarol20017(1)28-32.