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目的探讨经肝动脉灌注131I-HAb18F(ab’)2治疗肝癌合并门脉癌栓的价值。方法8例合并门脉癌栓的晚期肝癌患者行经肝动脉超选择灌注131I-HAb18F(ab’)2临床治疗性试验,剂量:0.75mCi/kg。分析症状、卡氏评分、肝功能、AFP及肿瘤CT等影像变化,随访近期疗效。结果7例疼痛患者中,3例症状缓解。3例卡氏评分增加、4例稳定。6例AFP异常患者治疗后3例下降。全组病例用药后肝功能损害均无明显加重。1例无明显症状的弥漫型肝癌患者治疗后病灶减少;余7例中,瘤体增大5例、缩小2例,其中,PR2例,临床有效率28.6%。本组1例1年随访时生存。结论经肝动脉灌注0.75mCi/kg131I-HAb18F(ab’)2对合并门脉癌栓的肝癌患者肝功影响小,对门脉分支癌栓患者有较好的疗效。
Objective To investigate the value of transcatheter arterial infusion of 131I-HAb18F (ab ’) 2 in the treatment of hepatocellular carcinoma with portal vein tumor thrombus. Methods Eight patients with advanced hepatocellular carcinoma with portal vein tumor thrombus underwent transcatheter hepatic arterial infusion of 131I-HAb18F (ab ’) 2 in a therapeutic dose of 0.75 mCi / kg. Analysis of symptoms, Karnofsky scores, liver function, AFP and tumor CT and other imaging changes, follow-up curative effect. Results Of the seven patients with pain, three had symptomatic relief. 3 cases of card’s score increased, 4 cases were stable. 6 cases of abnormal AFP patients after treatment decreased in 3 cases. The whole group of patients with no significant deterioration of liver function after treatment. One case of diffuse hepatocellular carcinoma without obvious symptoms reduced the number of lesions after treatment. In the other seven cases, the tumor size increased in 5 cases and contracted in 2 cases. Among them, PR2 cases achieved a clinical effective rate of 28.6%. The group of 1 case of survival at 1-year follow-up. Conclusions The hepatic effect of hepatic artery with hepatic artery perfusion with 0.75mCi / kg131I-HAb18F (ab ’) 2 in hepatic artery is small and has a good curative effect on patients with portal vein thrombosis.