奈达铂联合氟尿嘧啶栓塞治疗中晚期肝癌的临床观察  

Clinical observation on nedaplatin combined with fluorouracil by transcatheter arterial embolization for advanced primary liver carcinoma

作　　者：熊正平[1] 黄芳[2] 梁赵玉[1] 黄斌[1] 黄满平[1] 李国文[1] 古善智[1] 

机构地区：[1]湖南省肿瘤医院放射介入科,长沙410013 [2]湖南省肿瘤医院感染控制科,410013

出　　处：《临床肿瘤学杂志》2011年第11期1023-1025,共3页Chinese Clinical Oncology

摘　　要：目的探讨奈达铂(NDP)联合氟尿嘧啶(5-FU)方案栓塞治疗中晚期肝癌的疗效及安全性。方法 202例中晚期肝癌患者采用NDP联合5-FU方案与超液化碘油乳剂化疗栓塞治疗,具体为:NDP 100mg/m2行肝动脉灌注,5-FU1000mg/m2和超液化碘油5～40ml混合成乳剂行肝动脉栓塞。参照WHO抗癌药物毒性分级标准评价毒性反应,用Child-Pugh评分观察肝功能,并随访患者的总生存期(OS)。结果 202例中晚期肝癌患者获CR 11例,PR 108例,SD 42例,PD 41例,有效率为58.9%。主要的血液学毒性为中性粒细胞减少,其中1级39.6%,2级28.7%,3～4级18.8%;胃肠道反应为恶心呕吐,其中2～3级90.1%;术后41例由Child-Pugh A级升至B级,5例由Child-Pugh A级升至C级,11例由Child-Pugh B级升至C级;仅轻度肾功能损害。随访5～35个月,中位OS为17.5个月。结论 NDP联合5-FU方案配合超液化碘油乳剂栓塞治疗中晚期肝癌安全有效,并且能够改善患者的生活质量。Objective To evaluate the efficacy and safety of nedaplatin combined with fluorouracil by transcatheter arterial embolization for advanced primary liver carcinoma（PLC）. Methods Two hundred and two patients diagnosed as PLC were received transarterial chemoembolization（TACE）.During TACE,firstly,nedaplatin was infused intraarterially at dose of 100mg/m2,then fluorouracil at dose of 1000 mg/m2with ultra-lipoidal iodide oil（5-40ml）emulsion for arterial embolization were used.The toxicity and hepatic injury were observed according to WHO anticancer drug toxicity criterion and Child-Pugh classification criterion,respectively.The overall survival was also observed during follow-up. Results In 202 PLC patients,11 achieved CR,108 got PR,42 got SD,41 got PD,and overall response rate was 58.9%.The toxicity of blood was neutropenia： grade 1 was 39.6%,grade 2 was 28.7% and grade 3-4 was 18.8%.Grade 2-3 nausea and vomiting was 90.1%.Hepatic injury became aggravated in 41 from Child-Pugh A to B class,in 5 from Child-Pugh A to C class,and in 11 from Child-Pugh B to C class according to Child-Pugh classification criterion.The median overall survival was 17.5 months. Conclusion Nedaplatin combined with fluorouracil and ultra-lipoidal iodide oil emulsion is safe and effective in the management of patients with advanced PLC,which can improve quality of life.

关 键 词：原发性肝癌 化学栓塞 奈达铂 氟尿嘧啶 

分 类 号：R735.7[医药卫生—肿瘤]