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目的评价介入化疗栓塞在HCC肝移植后肿瘤复发治疗中的作用。方法12例原发性HCC肝移植后肿瘤复发、且失去外科治疗机会的患者接受1次或多次TACE治疗(平均每例2.28次)。通过治疗后的影像学资料判定治疗反应,并用Kaplan-Meier生存曲线计算患者生存率。结果12例中7例(58.3%)肿瘤体积缩小≥30%。然而,在随访期间有11例(91.3%)出现了肝内或肝外新发病灶。移植后1、2、3和4年生存率分别为83.3%、57.1%、47.6%和17.9%;复发后6、12和24个月生存率分别为66.7%,50%和31.3%。结论对于原发性HCC肝移植后肿瘤复发且失去外科切除机会的患者,介入化疗栓塞在一定程度上可以控制肿瘤生长。
Objective To evaluate the role of interventional chemotherapy embolization in the treatment of tumor recurrence after liver transplantation. Methods Twenty-two patients with recurrent tumor after primary HCC and one patient with no chance of surgical treatment underwent one or more TACE (mean 2.28). Treatment response was determined by post-treatment radiographic data and patient survival was calculated using Kaplan-Meier survival curves. Results Of the 12 cases, 7 (58.3%) tumors were reduced in size by 30% or more. However, 11 (91.3%) developed intrahepatic or extrahepatic lesions during follow-up. The 1, 2, 3 and 4-year survival rates after transplantation were 83.3%, 57.1%, 47.6% and 17.9%, respectively. The survival rates at 6, 12 and 24 months after transplantation were 66.7%, 50% and 31.3%, respectively. Conclusions Interventional chemoembolization may, to a certain extent, control tumor growth in patients with recurrent tumor recurrence after primary liver transplantation and loss of surgical resection.