王媒西, 赵圆圆, 杨博, 等. 不同抗肿瘤治疗方法对肝癌肝移植术后复发转移的疗效比较[J]. 器官移植, 2021, 12(3): 302-308. DOI: 10.3969/j.issn.1674-7445.2021.03.008
引用本文: 王媒西, 赵圆圆, 杨博, 等. 不同抗肿瘤治疗方法对肝癌肝移植术后复发转移的疗效比较[J]. 器官移植, 2021, 12(3): 302-308. DOI: 10.3969/j.issn.1674-7445.2021.03.008
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Wang Meixi, Zhao Yuanyuan, Yang Bo, et al. Comparison of clinical efficacy of different anti-tumor therapies for recurrence and metastasis after liver transplantation for liver cancer[J]. ORGAN TRANSPLANTATION, 2021, 12(3): 302-308. DOI: 10.3969/j.issn.1674-7445.2021.03.008
Citation: Wang Meixi, Zhao Yuanyuan, Yang Bo, et al. Comparison of clinical efficacy of different anti-tumor therapies for recurrence and metastasis after liver transplantation for liver cancer[J]. ORGAN TRANSPLANTATION, 2021, 12(3): 302-308. DOI: 10.3969/j.issn.1674-7445.2021.03.008
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不同抗肿瘤治疗方法对肝癌肝移植术后复发转移的疗效比较

Comparison of clinical efficacy of different anti-tumor therapies for recurrence and metastasis after liver transplantation for liver cancer

    摘要
  • 摘要:
      目的  分析不同抗肿瘤治疗方法对原发性肝癌（肝癌）肝移植术后复发转移的疗效。
      方法  回顾性分析145例肝癌肝移植受者的临床资料。分析肝癌肝移植受者术后总体生存情况及复发转移情况。比较不同抗肿瘤治疗方法治疗复发转移受者的效果。
      结果  65例受者（44.8%）发生了复发转移，中位复发时间为6个月。其中1例复发后再次行肝移植，因肠穿孔死亡；24例（37%）接受靶向药物治疗，中位带瘤生存期为22个月；11例（17%）接受放射治疗（放疗）或化学药物治疗（化疗），中位带瘤生存期为11个月；9例（14%）接受局部治疗（手术切除或射频消融），中位带瘤生存期为8个月；20例（31%）未接受抗肿瘤治疗，中位带瘤生存期为3个月。接受抗肿瘤治疗受者的带瘤生存期较未接受抗肿瘤治疗受者延长（P < 0.001）；接受靶向药物治疗受者的带瘤生存期较接受其他抗肿瘤治疗受者延长（P=0.03）；接受局部治疗和放、化疗受者的带瘤生存期较未接受抗肿瘤治疗受者延长（P=0.004）。
      结论  对于肝癌肝移植术后复发转移受者，首选手术切除和射频消融。对于无法接受局部治疗的多灶性肿瘤，使用靶向药物治疗的受者带瘤生存期最长，放、化疗亦能延长复发转移受者的生存期。

     

    Abstract:
      Objective  To analyze the clinical efficacy of different anti-tumor therapies for recurrence and metastasis after liver transplantation for primary liver cancer (liver cancer).
      Methods  Clinical data of 145 recipients undergoing liver transplantation for liver cancer were retrospectively analyzed. The overall survival and recurrence and metastasis after liver transplantation for liver cancer were analyzed. The clinical efficacy of different anti-tumor therapies for recipients with recurrence and metastasis were compared.
      Results  Sixty-five recipients (44.8%) developed recurrence and metastasis. The median recurrence time was 6 months. Among them, 1 case underwent secondary liver transplantation after recurrence and died of intestinal perforation. Twenty-four recipients (37%) received targeted drug therapy with a median tumor-bearing survival of 22 months. Eleven recipients (17%) received radiotherapy or chemotherapy with a median tumor-bearing survival of 11 months. Nine recipients (14%) received local treatment (surgical resection or radiofrequency ablation), and the median tumor-bearing survival was 8 months. Twenty recipients (31%) abandoned anti-tumor therapy, and the median tumor-bearing survival was 3 months. The tumor-bearing survival of recipients receiving anti-tumor therapy was significantly longer than that of recipients without anti-tumor therapy (P < 0.001). The tumor-bearing survival of recipients receiving targeted drug therapy was significantly longer than that of those receiving other anti-tumor therapies (P=0.03). The tumor-bearing survival of recipients receiving local treatment, radiotherapy and chemotherapy was considerably longer than that of those who abandoned anti-tumor therapy (P=0.004).
      Conclusions  Surgical resection and radiofrequency ablation are the optimal therapies for recipients with recurrence and metastasis after liver transplantation for liver cancer. For recipients with multi-focal tumors who fail to receive local treatment, those receiving targeted drug therapy obtain the longest survival. In addition, radiotherapy and chemotherapy can also prolong the survival of recipients with recurrence and metastasis.

     

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