TACE联合亚砷酸治疗原发性肝癌的疗效观察  

The clinical therapeutic effects of transcatheter hepatic arterial chemoembolization combined with arsenic trioxid in the treatment of primary hepatic carcinoma

作　　者：陈维[1] 魏涛[1] 邹三鹏[1] 刘倩平[1] 

机构地区：[1]广州市花都区人民医院,广东广州510800

出　　处：《基层医学论坛》2009年第34期1069-1070,共2页The Medical Forum

摘　　要：目的评价TACE联合持续灌注As2O3治疗原发性肝癌的临床疗效及不良反应。方法对21例不能手术切除的原发性肝癌患者,采用顺铂40mg、丝裂霉素10mg、5-氟尿嘧啶0.75g和碘油10～30ml行TACE治疗;之后埋置皮下化疗泵,予以持续肝动脉灌注As2O3,剂量为20mg/d,每天1次,共7d,间隔4周重复,共2～5个疗程。结果21例中CR0例(0%),PR10例(47.6%),SD9例(42.9%),PD2例(9.。5%客)观有效率(CR+PR)为47.6%,获益率(CR+PR+SD)为90.5%,AFP下降率为80.0%;毒性反应主要为发、热胃肠道反应、血液学及肝脏毒性。结论TACE联合肝动脉持续灌注As2O3用于治疗原发性肝癌疗效确切,不良反应轻,值得临床进一步推广。Objective To study the clinical therapeutic effects and the side effects of transcatheter hepatic arterial chemoembolization（TACE ）combined with arsenic trioxide（ As2O3）continuous hepatic arterial infusion in the treatment of primary, hepatic carcinoma. Methods Twenty-one patients with unresectablc primary hepatic carcinoma were received the treatment of TACE using DDP 40 mg,mitomycin 10 mg,5-fluorouracil 0.75g and lipiodol 10-30 ml, and then were received As2O3 continuous hepatic arterial infusion through the chemotherapy pump placed beneath the skin, 20 mg/d, qd × 7, and the treatment was repeated every four weeks with 2-5 cycles. Results Among the 21 patients, 0 case was in complete response （ CR ） ; 10 cases were in partial response （ PR ） （ 47.6% ） ; 9 cases were stable （ SD ） （ 42.9% ） ; 2 cases were in progress （PD） （9.5 % ）;objective response rate （CR＋PR） was 47.6% ;clinical beneficial response rate （CR＋PR＋SD）was 90.5% ;the rate of AFP descent was 80.0%.The major side effects were fever,digestive tract side effect, hepatic and hemotological toxicity.Conclusion TACE combined with As2O3 continuous hepatic arterial infusion is effective and safe in the treatment of primary hepatic carcinoma, and has wide clinical application perspective.

关 键 词：亚砷酸 持续灌注 肝动脉化疗栓塞 原发性肝癌 

分 类 号：R735.7[医药卫生—肿瘤]