中晚期原发性肝细胞肝癌的热化疗加热栓塞治疗  

Dual-thermotherapy for parenchymal hepatic cells carcinoma

作　　者：王文辉[1] 李奋强[1] 郭铮[1] 苏东君[1] 李博[1] 宋来昌[1] 

机构地区：[1]兰州大学第一医院介入医学科,兰州730000

出　　处：《北京大学学报（医学版）》2008年第2期125-128,共4页Journal of Peking University:Health Sciences

摘　　要：目的:研究经肝动脉"双热"(热化疗加热栓塞)治疗肝癌的有效性和安全性。方法:双热组(dual-thermo-therapy,DT)50例肝癌患者经肝动脉插管行"双热"治疗,将碘油加热至80℃,依次将1000mg的5-Fu(50mL)、400mg的卡铂(300mL)加热至50℃后经导管注入肝动脉,然后注入表阿霉素40mg(其高温下欠稳定,未加热)。TACE组50例肝癌患者在室温(23℃)下经导管灌注化疗,碘油及化疗药物(种类、剂量、灌注途径及方法均与DT组一致)均不加热。结果:DT组术后1年、2年、3年的生存率分别为77.6%、53.1%和46.1%,TACE组分别为54.4%、24.2%和16.1%,两组相比差异有统计学意义(P<0.05)。DT组的生存曲线明显高于TACE组。治疗副反应中,局部烧灼感(患者数/持续时间)两组相比差异有统计学意义,其余副反应两组比较未见明显差异。结论:经肝动脉"双热"治疗肝癌是简单、安全有效的方法,比室温下的TACE治疗有明显的优越性。Objective： To study the efficacy and safety of transhepatic arterial ＂dual-thermotherapy＂ （DT） for parenchymal hepatic cells carcinoma. Methods： Fifty patients （mean age 55.5 years, DT group） with parenchymal hepatic cells carcinoma were treated with transhepatic arterial thermochemotherapy with warmed lipiodol （80 ℃ ） and warmed chemotherapehtic agents （50 ℃ ）. Another 50 patients （mean age 54 years） were treated with ordinary transhepatic arterial chemomembolization （TACE） with the same chemotherapeutic drugs but without warming （TACE group）. Results： The 1-, 2-, and 3-year survival rates were 77.6%, 53.1% and 46.1%, respectively, in TD group; and 54.4%, 24.2% and 16.1%, resectively, in TACE group; the difference was statistically significant（ P 〈 0.05）. The sideeffect of the feeling of cauterization （cases/persistence time） in DT group was statistically significant compared with TACE group （ P 〈 0.05） , and the difference was not statistically significant about other side-effects. Conclusion： Tanshepatic arterial perfusion of warmed lipiodol （80 ℃ ） and chemotherapeutic agents （50 ℃）, namely, ＂dual-thermotherapy＂ is a simple, safe and effective method for treating hepatic carcinoma with less complications than ordinary TACE.

关 键 词：癌 肝细胞 高温 诱发 治疗结果 

分 类 号：R735.7[医药卫生—肿瘤]