皮下植入中人氟安联合静滴亚砷酸治疗晚期肝癌临床研究  

Treatment of advanced hepatocellular carcinoma with combination regimen of subcutaneous implant of 5-fluorouracil sustained-release plus intravenous infusion of arsenous acid

作　　者：陈昌南[1] 潘岐作[1] 黄活勋[1] 林云笑[1] 苏铭俊[1] 梁少俊[1] 林大任[2] 杨劲松[3] 钟妙文[3] 

机构地区：[1]广东江门市新会区人民医院肿瘤内科,广东江门529100 [2]广东江门市中心医院,广东江门529000 [3]广东江门市新会区中医院,广东江门529100

出　　处：《现代肿瘤医学》2008年第2期243-245,共3页Journal of Modern Oncology

基　　金：广东省医学科研基金课题(编号:A2006716)

摘　　要：目的:探讨晚期肝癌新疗法皮下植入中人氟安联合静滴亚砷酸的疗效及毒副作用。方法:治疗组33例晚期肝癌和术后或介入术后复发的病例,一次皮下植入中人氟安400mg-480mg;静滴亚砷酸(三氧化二砷)每日10mg,连用14天为一疗程,每4周-6周重复,评价疗效、毒副反应、生存质量(KPS评分)、生存期等情况,与对症治疗组46例进行对比。结果:治疗组33例病例均能耐受,其中完成3疗程7例(21.21%),2疗程14例(42.42%),1疗程12例(36.36%);出现胃肠道反应(腹胀或加重,或伴恶心、呕吐)12例(36.36%);肝功能异常或黄疸加重10例(30.30%);Ⅰ°-Ⅱ°骨髓抑制9例(27.27%);植入区皮肤非感染性皮炎22例(66.67%),其中并感染4例(12.12%),KPS提高17例(51.52%),稳定7例(21.21%),下降9例(27.27%);CT或MRI评价:CR0例,PR8例(24.24%),NC13例(39.39%),PD12例(36.36%),临床获益(显效)(CR+PR+NC)21例(63.36%),中位生存期6.7月,比对照组的3.4月长,P<0.01。结论:初步临床研究表明,皮下植入中人氟安联合静滴亚砷酸治疗晚期肝癌有63%显效率,平均延长寿命3月余,两药有协同作用,毒副反应轻,能耐受,值得进一步扩大临床研究和加强机理探讨。Objective ：To investigate the efficacy, side effect of combination therapy of subcutaneous implant of 5 - fluorouracil sustained - release plus intravenous infusion of arsenous acid in advanced hepatocellular carcinoma. Methods ： The study enrolled 79 patients with advanced hepatocellular carcinoma, some of them relapse postoperatively. 33 patients were treated with a combination regimen of a subcutaneous implant of 5 - fluorouracil sustained - release（400mg -480mg） plus intravenous infusion of arsenous acid （ 10mg per day ） for a course of treatment （ 14 days） . Another course of treatment would be repeated in 4 -6 weeks later. The other 46 patients got symptomatic treatment. The efficacy, side effect, scores of Karnofsky PS （KPS） was observed. Results： 33 patients treated with a combination regimen were tolerant, 7 of them（21.21% ） got 3 courses of treatment, 14（42.42% ） got 2 courses of treatment, 12（36.36% ）got 1 course of treatment, 12 of them （36.36%）had side effects of alimentary canal, such as abdominal distention, nausea and emesis, 10 （30.30%） had hepatic function deterioration or aggravated jaundice, 9（27.27% ）had bone marrow depression（Ⅰ°- Ⅱ°）, 22（66.67% ）had dermatitis caused by subcutaneous implant, 4（12. 12%） had infected dermatitis,17 （51. 52%） improved their KPS, 7 （21. 21%） had on change, 9 （27.27 % ） decreased their KPS, all the patients were evaluated by CT or MR1： CR 0, PR 8 （24.24%）, NC 13 （39.39%） ,PD 12（36.36% ）, （CR ＋ PR ＋ NC）21 （63.36%）, median lifespan：6.7months in the patients treated with a combination regimen compared to 3.4 months in patients with symptomatic treatment, P 〈 0.01. Conclusion： The effective power of patients treated with a combination regimen was 63%. Combination regimen could prolong average life over 3 months and had synergism, efficacy, low side effect and high survivability.

关 键 词：肝癌 联合用药 中人氟安 亚砷酸 

分 类 号：R735.7[医药卫生—肿瘤]