肝动脉灌注羟基喜树碱和栓塞治疗原发性肝癌  

Treatment of hepatocellular carcinoma by transcatheter arterial chemoembolization with hydroxycamptothecin

作　　者：涂水平[1] 吴达明[1] 袁耀宗[1] 吴云林[1] 江石湖[1] 吴裕忻[1] 

机构地区：[1]上海第二医科大学瑞金医院

出　　处：《世界华人消化杂志》1999年第2期158-160,共3页World Chinese Journal of Digestology

摘　　要：目的观察经肝动脉插管栓塞和灌注化疗药物羟基喜树碱、５ＦＵ、丝裂霉素（ＭＭＣ）、顺铂治疗（ＴＡＣＥ）进展期肝癌（ＨＣＣ）２１例的疗效和副作用．方法应用ＴＡＣＥ治疗２１例中晚期ＨＣＣ患者，其中Ⅱ期１５例，Ⅲ期６例．结果接受ＴＡＣＥ患者２１例，治疗总有效率为８０９％，平均生存期９１ｍｏ，半年和一年生存率分别为７１５％和４２４％．Ⅱ期患者获得的平均生存期、半年和一年生存率分别为１０５ｍｏ，８６７％，６０％；明显优于Ⅲ期患者的５３ｍｏ，３６７％，０％（Ｐ＜００１）．多次治疗的平均生存期为１１２ｍｏ，明显优于单次治疗的６８ｍｏ（Ｐ＜００１）．副作用有恶心、呕吐、发热、白细胞下降和肝功能异常．结论羟基喜树碱经肝动脉灌注联合栓塞是治疗进展期ＨＣＣ的有效手段．AIM To evaluate the therapeutic efficacy of transcatheter arterial chemoembolization (TACE) with hydroxycamptothecin, 5 Fluorouracil, mitomycin and ciplatin on advanced hepatocellular carcinoma(HCC). METHODS Twenty one patients with HCC were treated with TACE. There were 15 cases of stage Ⅱ and 6 cases of stage Ⅲ. RESULTS CR was achieved in 2 cases, PR in 15 cases, S in 3 cases with an overall response rate of (CR+PR) 80 9%. The mean survival time was 9 1 months. The survival rates of the 21 cases were 71 5% for 6 month, and 42 4% for 1 year. For patients in stage Ⅱ, the average survival time, the 6 month and 1 year survival rates were 10 5 months, 86 7%, 60 0%, respectively. There was a better therapeutic efficacy for patients in stage Ⅱ than for those in stage Ⅲ ( P <0 01). The patients with multiple TACE had longer survival time (11 2 months) than that (6 8 months) of those patients with only one TACE. The common adverse reactions were nausea, vomiting, fever, leukopenia, and elevation of ALS/AST . CONCLUSION TACE with hydroxycamptothecin is an effective, well tolerated regimen for patients with HCC, and is worthy of further studies.

关 键 词：肝癌 羟基喜树碱 栓塞治疗 肝动脉灌注 

分 类 号：R735.705[医药卫生—肿瘤] R730.53[医药卫生—临床医学]