肿瘤化疗药物常见分类课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,肝癌并门静脉癌栓的治疗,南华大学附属第一医院,朱红波,肝癌并门静脉癌栓的治疗,1,流行病学,发生率约125%397%,中位生存时间为:2.7-40月,Villa E, et al. Hepatology, 2000, 32(2): 233-238,Kuo YH, et al. Eur J Cancer, 2010, 46(4): 744-751,Minagawa M et al.World J Gastroenterol, 2006, 12(47)7561-7,流行病学,2,B超或超声造影,增强CT,增强MR,B超或超声造影,3,Type lla,上海分型,西安分型,日本分型,Type Ila,Type Ivb,Type lla,4,分型及亚型,1a型:显微镜下癌栓形成,1癌栓累及门静路一分学,型:癌栓累及二级及二级以上门静脉分,。型:癌栓累及冂门静脉三级及,l型:癌栓累及一级门静脉分支,Type lla,pe,型:癌栓累及一叶一级门静脉分支,Il型:癌栓累及二叶一级门静脉分支,型:癌栓累及门静脉主干,l型:癌栓累及门慘脉主干、门静脉左右干汇合处以下,不超过2,型:癌栓累及门静脉主干、门静脉左右干汇合处以下,Type Ila,型:癌栓累及肠系膜上静脉或下腔静脉,型:癌栓累及肠系膜上静脉,V型:癌栓累及下腔静脉,分型及亚型,5,HEPATOLOGY, Vol. 51, No, 4, 2010,A Meta-Analysis of Survival Rates of Untreated,Patients in randomized clinical trials of,Hepatocellular carcinoma,Giuseppe Cabibbo, L 4 Marco Enea, Massimo Attanasio, Jordi Bruix, 3 Antonio Craxi, and Calogero Cammal,5,合并肉眼PVTT( BCLC O期),未经治疗情况,下中位生存时间为6月,1年生存率25%,Llovet JM et al. Hepatology 1999; 29: 62-67,Cabibbo g et al. Hepatology, 2010: 51: 1274-1283,Llovet JM et al. Hepatology, 2008 48: 1312-1327,HEPATOLOGY, Vol. 51, No, 4, 20,6,AC期,STU, Child-Pugh A,PST0-2. Child-PughA,PST2, Child-Pugh C,更早期(U),早期(A),中期(B),晚期(c)末期(D),单个60个月;5年生存率:40%70%,os:20个月(4514os:个月(6-14)0s3个月,EASL-EORTC Clinical Practice Guidelines. J Hepatology, 2012, 56: 908-943,PST0-2, Child-PughA,8,Minagawa M et al. Annals of surgery, 2007; 245: 909-22,Chen XP et al. annals of surgical oncology, 2006; 13: 94-6,Peng ZW et al. Cancer, 2012, 118 (19): 4725-36,Yau T et al. Gastroenterology, 2014(7): 1691-700,Pawlik TM et al. Surgery, 2005; 137: 403-410,复发,生存,情况,(%),疗方式息中位6月门1年肝1年2年3年5年P,幸生存静脉内复,发时间内复发,Minagawa M et al. Annals of su,9,ann surg onc208J,137)940.E208May23.,Effects of location and extension of portal vein tumor thrombus on long- term outcomes of surgical,treatment for hepatocellular carcinoma,Chen XP1 Qiu FZ Wu ZD, Zhang ZW, Huana, Chen YE Zhand BX He SO, ZhanaWG,Author information,BACKGROUND: The role of surgical resection and thrombectomy for hepatocellular carcinoma (HCC) with portal vein tumor thro,(PVTT) is controversial This study aimed to evaluate the efects of the location and extent of Pvtt an the long-erm outcomes of surgical,METHODS. A total of 438 patients with HCC and PVTT underwent Iver resection w or without thrombectomy. These 438 patents were,divided into 2 groups in group A, PVI I was located in the hepatic resection area or protruded into the first branch of the main portal vein,beyond the resection line for 1 cm(286 patients), and in group B PvTT extended into the main portal vein(152 patients ) Concomitant,thrombectomy was performed in 147 patients(51.4%)of group a and in all patients of group B,RESULTS: PVTT recurrence within 6 months afer surgery in group B was significantly higher than that in group A: 76.9%Vs. 11.3%,Remnant liver recurrence within 1 year after,45.0% In group A and 78.8% in group B. The cumulative 1- 2.3, and 5-year,overall survival ra:es were 58.7%, 39.9%, 22.79, and 18.1% for group A and 39.5%, 20.4%, 5.7%, and O% for group B, respectively. The,overall survivals were signific antly better in group a than group B(P.02),CONCLUSION S: Liver resection with thrombectomy yielded better outcomes in the HCC patients with PVTT confined to the first or second,branch of the main portal vein compared with PvTT extending into the main portal vein,ann surg onc208J,137)940.E208M,10,肿瘤化疗药物常见分类课件,11,肿瘤化疗药物常见分类课件,12,肿瘤化疗药物常见分类课件,13,肿瘤化疗药物常见分类课件,14,肿瘤化疗药物常见分类课件,15,肿瘤化疗药物常见分类课件,16,肿瘤化疗药物常见分类课件,17,肿瘤化疗药物常见分类课件,18,肿瘤化疗药物常见分类课件,19,肿瘤化疗药物常见分类课件,20,肿瘤化疗药物常见分类课件,21,肿瘤化疗药物常见分类课件,22,肿瘤化疗药物常见分类课件,23,肿瘤化疗药物常见分类课件,24,肿瘤化疗药物常见分类课件,25,肿瘤化疗药物常见分类课件,26,肿瘤化疗药物常见分类课件,27,肿瘤化疗药物常见分类课件,28,肿瘤化疗药物常见分类课件,29,肿瘤化疗药物常见分类课件,30,肿瘤化疗药物常见分类课件,31,肿瘤化疗药物常见分类课件,32,肿瘤化疗药物常见分类课件,33,肿瘤化疗药物常见分类课件,34,肿瘤化疗药物常见分类课件,35,肿瘤化疗药物常见分类课件,36,肿瘤化疗药物常见分类课件,37,肿瘤化疗药物常见分类课件,38,肿瘤化疗药物常见分类课件,39,肿瘤化疗药物常见分类课件,40,肿瘤化疗药物常见分类课件,41,肿瘤化疗药物常见分类课件,42,肿瘤化疗药物常见分类课件,43,肿瘤化疗药物常见分类课件,44,肿瘤化疗药物常见分类课件,45,肿瘤化疗药物常见分类课件,46,肿瘤化疗药物常见分类课件,47,肿瘤化疗药物常见分类课件,48,肿瘤化疗药物常见分类课件,49,肿瘤化疗药物常见分类课件,50,肿瘤化疗药物常见分类课件,51,肿瘤化疗药物常见分类课件,52,肿瘤化疗药物常见分类课件,53,肿瘤化疗药物常见分类课件,54,肿瘤化疗药物常见分类课件,55,肿瘤化疗药物常见分类课件,56,