持续榄香烯乳经皮左锁骨下动脉植入药盒灌注化疗转移性肝癌的临床研究  

Lemene emulsion continuity arterial infusion chemotherapy via percutaneous left subclavain artery implantation of port-catheter drug delivery system for non-resectable liver metastases

作　　者：谭诗生[1] 李杭[1] 李雪松[2] 庞尊中[2] 陈南江[1] 李磊[1] 

机构地区：[1]贵州省人民医院肿瘤科,550002 [2]贵州省人民医院放射介入科,550002

出　　处：《中国实用医药》2008年第30期12-14,共3页China Practical Medicine

摘　　要：目的评价持续榄香烯乳经皮左锁骨下动脉植入药盒导管系统(PCDDS)灌注化疗转移性肝癌的临床疗效。方法1997～2006年,31例晚期转移性肝癌患者接受了持续榄香烯乳联合化疗药物动脉经PCDDS灌注化疗。PCDDS介入化疗方案:阿霉素40mg/m2(第1天),顺铂40mg/m2(第1天),5-氟尿嘧啶1.0g/m2(第2～3天持续48h动脉泵入),灌注5-氟尿嘧啶使用亚叶酸钙0.3g经外周静脉2h滴入。榄香烯乳300mg每日经PCDDS灌注治疗,连续20d为1个周期,每4～6周重复1次。化疗2个周期后评价近期临床疗效、不良反应和生活质量,如有效继续治疗至疾病进展。结果31例患者共进行了185个周期PCDDS灌注化疗,平均6.5个周期(2～10个)。其中2例CR(6.6%),20例PR(64.5%),总有效率为71.0%。生存期3.52～43.20个月,中位生存期17.6个月,中位疾病无进展时间(PFS)为11.3个月,1、2年生存率分别为65.23%和32.65%。主要不良反应包括3～4度消化道反应(9.7%,3/31),3～4度中性粒细胞减少症(12.9%,4/31),3～4度肝功能损害(9.7%,3/31),1例患者出现了导管漏液而拔管。23例(74.2%)患者KSP评分得到提高。结论持续榄香烯乳联合化疗药物经PCDDS灌注治疗转移性肝癌安全有效,耐受性好。Objective To evaluate the therapeutic effect of elemene emulsion via implanted Port-catheter drug delivery system （PCDDS） in patients with non-resectable liver metastases. Methods From 1997 to 2006,31 patients with non-resectable liver metastases received element emulsion combined DDP, ADM, 5-FU/ CF via PDDS hepatic intra-arterial infusion chemotherapy. （ Chemotherapy regimen： ADM 40 mg/m^2 dl, q4 - 6w,DDP 40 mg/m^2 dl, q4 - 6w,5-FU 1000 mg/m^2 d2 -3 24 hours continue infusion by mini-pump q4 -6w, Folic acid 300 mg via vein transfuse for 3 hours before 5-FU d2 q4 - 6w,5-FU 167mg/（ m^2 · day）continuously for 3 months and then 334 mg/m^2 qw, Elemene emulsion 300 mg/d dl - 20 q4 - 6w）. Results After 2 - 10 （ 185 cycles/31 patients, average 6. 5 cycles） cycles of chemotherapy, Response rates evaluated by CT-scan were 71.0% （2 CR ＋ 20 PR/31 ）. The survival time ranged from 3.52 to 43.2 months（ median 17. 6 months）. 1-year and 2-year overall survival rates were 65.23% and 32. 65% o 3 patients experienced grade 3 ~4 digestive sideeffect. Four patients displayed grade 3 - 4 neutropenia. There were grade 3 - 4 damage of liver in three patients. There were no severe damage of kidney and heart. One patient had to be extubated because of the catheter＇ s weeping. There were no other catheter-related complications. The life quality of 23 patients had increased. Conclusion Lemene emulsion continuity intra-arterial infusion chemotherapy with PCDDS for non-resectable liver metastases is safe and effective and merits further evaluation.

关 键 词：榄香烯乳 皮下植入动脉药盒系统 转移性肝癌 持续灌注 

分 类 号：R735.7[医药卫生—肿瘤] R730.55[医药卫生—临床医学]