中文摘要：

目的评价血管内近程放疗（endovascular brachytherapy,EVBT）联合支架植入及经动脉化疗栓塞（transarterial chemoembolization,TACE）治疗肝细胞肝癌（hepatocelluar carcinoma,HCC）合并门脉主干癌栓（main portal vein tumor thrombus,MPVTT）的安全性及疗效。方法对2009年1月至2014年12月在复旦大学附属中山医院接受支架植入及TACE治疗的289例HCC合并MPVTT患者的病例资料进行回顾性分析,其中194例（研究组）同期在门脉主干内植入碘-125粒子条,余95例未接受EVBT的患者作为对照组。对两组患者的生存期、无疾病进展生存期、支架通畅期及治疗相关不良事件的发生率进行比较。结果所有碘-125粒子条及支架均准确植入门脉主干梗阻段,无严重治疗相关不良事件发生。平均随访（10.1±5.2）个月,研究组及对照组的中位生存期分别为（9.3±1.1）及（4.9±0.5）个月（P〈0.001）,中位无疾病进展生存期分别为（6.0±0.3）及（3.0±0.1）个月（P〈0.001）,中位支架通畅期分别为（11.0±1.1）及（4.8±0.3）个月（P〈0.001）。结论血管内EVBT联合支架植入及TACE治疗HCC合并MPVTT安全、有效。

英文摘要：

Objective To evaluate the safety and efficacy of endovascular implantation of iondine-125（125I）seeds strand and stent combined with transarterial chemoembolization（TACE）to treat hepatocellular carcinoma（HCC）with main portal vein（MPV）tumor thrombus（MPVTT）. Methods Data on treatment with intra-portal vein stent placement and TACE in 289 consecutive HCC patients with MPVTT,from Jan.,2009 to Dec.,2014 in Zhongshan Hospital of Fudan University were analyzed retrospectively.Synchronal implantation of 125 I seeds strand in MPV was performed in 194patients（study group）.The remaining 95 patients who refused endovascular brachytherapy served as control（control group）.The overall survival,free of disease progression survival,stent patency period and procedure-related adverse events were compared between the two groups. Results All 125 I seeds strand and stent were implanted in obstructed MPV correctly without serious procedurerelated adverse events.During a mean of（10.1±5.2）months＇ follow-up,the median survival was（9.3±1.1）months in study group,while it was（4.9±0.5）months in control group,respectively（P〈0.001）.Median free of disease progression survival in study and control group was（6.0±0.3）months and（3.0±0.1）months（P〈0.001）.Median stent patency period was（11.0±1.1）months in study group and（4.8±0.3）months in control group,respectively（P〈0.001）. Conclusions These findings suggested that endovascular implantation of 125 I seeds strand and stent combined with TACE was potentially a safe and effective treatment option for patients with HCC and MPVTT.