^(131)I抗AFP抗体-MMC双弹头导向治疗肝癌31例  

Double bullet radioimmunotargeting therapy in 31 patients with primary liver cancer

作　　者：吴英德[1,2] 周德南[1,2] 甘友全[1,2] 胡晓桦[1,2] 李志革[1,2] 宋向群[1,2] 贺海平[1,2] 杨克政[1,2] 黄秉琰[1,2] 

机构地区：[1]广西医科大学附属肿瘤医院化疗科 [2]广西肿瘤防治研究所

出　　处：《新消化病学杂志》1997年第7期415-416,共2页

基　　金：国家八五科技攻关基金

摘　　要：目的观察化疗兼内照射的新型双弹头免疫导向治疗肝癌的疗效．方法以马抗人ＡＦＰ多克隆抗体（抗ＡＦＰＡｂ）和大鼠抗人ＡＦＰ单克隆抗体（抗ＡＦＰＭｃＡｂ）为载体，核素１３１Ｉ和丝裂霉素（ＭＭＣ）为双弹头，采用改良氯胺Ｔ法制备１３１Ｉ抗ＡＦＰＭｃＡｂＭＭＣ（双弹头１）和１３１Ｉ抗ＡＦＰＡｂＭＭＣ（双弹头２），静脉滴注，每月１次，治疗不能切除中晚肝癌３１例（治疗组）．治疗１，２，３次分别占４，１７和１０例，放射剂量（ＭＢｑ／例）均值依次为１９３５１±３７７４，６５１９±２３２４和９９２０±２３０５．结果治后肿瘤缩小率、血清ＡＦＰ下降率和１，２年生存率分别高于同期经动脉插管灌注（ＴＡＩ）或化疗栓塞（ＴＡＣＥ）的对照组（５００％，１５／３０比３００％，９／３０Ｐ＜００５；６６７％，１８／２７比２８０％，７／２５Ｐ＜００１和５００％比３３０％，３４０％比３３％Ｐ＜００１），治疗组病例的进展率（１００％）明显低于对照组（４００％，Ｐ＜００１）．结论双弹头疗效提高，由于抗体、核素１３１Ｉ和抗癌药的协同作用而增强了对癌细胞的杀伤力所致．AIM To observe the effect of a double bullet immunotargeting therapy with the merit of chemotherapy and internal radiotherapy for primary liver cancer. METHODS The polyclonal horse antibody against human AFP (anti AFPAb) and the monoclonal murine antibody against human AFP (anti AFPMcAb) were used as carriers, and 131 I and mitomycin C (MMC) as warheads, to form double bullet, ie, 131 I anti AFPMcAb MMC (double bullet 1) and 131 I anti AFPAb MMC (double bullet 2) prepared by the modified chloramine T method. The double bullet targeting therapy was administered by intravenous drip once a month in 31 patients (treatment group) with unresectable primary liver cancer. Among them 4, 17 and 10 patients were administered 1, 2 and 3 times, and the median value of radiation dose (MBq/case) were 193 5±37 74; 651 9±232 4, and 992 0±230 5 respectively. RESULTS The shrinkage of tumor, AFP decrease and 1 and 2 year survival rates were significantly higher than those of the control groups of transarterial infusion (TAI) or transarterial chemoembolization (TACE) at the same time (50 0%, 15/30 vs 30 0%, 9/30, P <0 05; 66 7%, 18/27 vs 28 0%, 7/25, P <0 01 and 50 0%, 34 0% vs 33 0%, 3 3%, P <0 01, respectively). Furthermore, the tumor progression rate (10%) in treatment group was significantly lower than that of control group (40 0%, P <0 01). CONCLUSION Double bullet target therapy has a better effect due to the synergistic effects of antibody, radioisotope, and anticancer agents, thus enhancing the tumor killing effect.

关 键 词：肝癌 免疫疗法 甲胎蛋白类 丝裂霉素 抗体 

分 类 号：R735.705[医药卫生—肿瘤]