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Rofo 2000; 172(1): 43-50
DOI: 10.1055/s-2000-279
ABDOMEN
Georg Thieme Verlag Stuttgart ·New York

Multisequentielle arterielle Chemoembolisation fortgeschrittener hepatozellulärer Karzinome: Computertomographische Verlaufsparameter zur Beurteilung des Ansprechens auf die Therapie

Transarterial Chemoembolization of Advanced Hepatocellular Carcinoma: CT Parameters for Evaluating the Response to Therapy.T. J. Vogl1 , H. Schroeder1 , M. Trapp1 , R. Straub1 , A. Schuster1 , B. Djavidani1 , M. Schuster1 , M. Mack1 , F. Souchon1 , P. Neuhaus2
  • 1Institut für Diagnostische und Interventionelle Radiologie, Klinikum der J. W. v. Goethe-Universität, Frankfurt am Main
  • 2Chirurgische Klinik, Virchow Klinikum, Humboldt Universität Berlin
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Publication History

Publication Date:
31 December 2000 (online)

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Zusammenfassung.

Evaluierung computertomographischer und klinischer Parameter zur Verlaufskontrolle der interventionellen Therapie des hepatozellulären Karzinoms (HCC) mittels transarterieller Chemoembolisation (TACE). Material und Methodik: Retro- und prospektive Verlaufsbeurteilung von 123 TACE Therapiezyklen bei 37 Patienten mit HCC mit einem Altersmittelwert von 63,3 Jahren. Ergebnisse: Die Überlebenszeit im Gesamtkollektiv betrug 785 Tage (± 88,7) im Mittel und 387 Tage median. Die 1-Jahresüberlebenswahrscheinlichkeit lag bei 62 %. Für die quantitative Evaluierung der Tumorvolumina im Verlauf errechnete sich eine statistisch signifikante Differenz der Überlebensraten von im Mittel 678 Tagen für eine Verringerung des Tumorvolumens um 0 - 50 % (Kat. 1) (n = 18), von 976 Tagen für eine Verringerung des Tumorvolumens um 51 - 100 % (Kat. 2) (n = 12) sowie von 277 Tagen für eine Zunahme des Tumorvolumens (Kat. 3) im Verlauf. Ein signifikant besseres Überleben ließ sich ermitteln für Tumoren mit geringer Lipiodolentspeicherung (0 - 50 % Entspeicherung), als prognostisch vorteilhaft erwies sich ein homogener intratumoraler Lipiodoleinlagerungstyp. Schlußfolgerung: Bei bildmorphologischen Kriterien eines primären Therapieansprechens nach TACE kann die Prognose durch Reembolisationen verbessert werden.

Purpose: An evaluation of clinical and computed tomography parameters for the transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). Material and Methods: Retro- and prospective analysis of 123 TACE procedures in 37 patients (mean age: 63.3 years). Results: Overall mean survival rate for all treated patients was 785 days with a mean value of 387 days. The 1 year survival rate was 62 %. Quantitative tumor volumetry revealed a significant difference in survival rate with a mean value of 678 days for patients with a reduction of tumor volume between 0 and 50 %, 976 days for a volume reduction of 51 - 100 % and 277 days for an increase in tumor volume during therapy. Patients with a high lipiodol retention presented improved survival data (902 days) versus patients with a low lipiodol retention (513 days). Homogeneous retention of lipiodol was a positive factor on survival as compared to an inhomogenous form of retention. Conclusion: In patients with a positive therapy response after TACE the prognosis can be improved by repeated embolization.

Schlüsselwörter:

Transarterielle Chemoembolisation (TACE) - Chemoembolisation - Computertomographie - HCC - Volumetrie

Key words:

Transarterial chemoembolization (TACE) - Hepatocellular carcinoma - Computed tomography (CT)

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Prof. Dr. Univ. Th. J. Vogl

Institut für Diagnostische und Interventionelle Radiologie J. W. v. Goethe Universität Frankfurt

Theodor-Stern-Kai 7

63590 Frankfurt

Email: Vogl@em.uni.Frankfurt.de

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