暂时闭塞肝静脉行肝动脉化疗栓塞治疗原发性肝癌时5—FU的血药浓度比较研究  

A Comparative Study of 5-FU Concentration in Transcatheter Arterial Chemoembolization with Temporary Hepatic Venous Occlusion in Primary Liver Cancer (PLC)

作　　者：刘嵘[1] 王建华[1] 颜志平[1] 周康荣[1] 邵国良[1] 王小林[1] 钱晟[1] 刘清欣[1] 罗剑钧[1] 龚高全[1] 

机构地区：[1]上海医科大学中山医院放射科,200032

出　　处：《中国临床医学杂志》2000年第2期146-148,共3页

基　　金：本课题系"九五"国家医学科技攻关项目!专题号:96-907-03-01

摘　　要：目的：研究暂时闭塞肝静脉行肝动脉化疗栓塞（ＴＡＣＥ－ ＴＨＶＯ）治疗原发性肝癌时 ５－ ＦＵ血浆药物浓度的变化，探讨肝ＴＡＣＥ—ＴＨＶＯ的适应证。方法：２０例原发性肝癌行ＴＡＣＥ—ＴＨＶＯ术。其中巨块型肝癌５例，结节型肝癌１０例，弥漫型肝癌５例。肿瘤局限于肝右叶１５例，跨叶或弥漫生长５例，肝动－静脉癌５例。采用高效液相色谱法测定肝右静脉、肝静脉入下腔静脉口处、外周静脉５—ＦＵ血浆药物浓度。结果：肝右静脉血浆５—ＦＵ平均血药浓度明显高于其它两个部位的血药浓度，且持续时间长。肿瘤局限于肝右叶者肝右静脉药物高浓度的平均持续时间为 １５ ｍｉｎ，肿瘤跨叶或弥漫生长者为 ７ｍｉｎ。肝癌不伴肝动－静脉瘦者平均持续时间为 １４ ｍｉｎ，有动－静脉瘘者为 ５ ｍｉｎ。结论：肝 ＴＡＣＥ—ＴＨＶＯ术能明显提高肿瘤局部５—ＦＵ的血药浓度，延长５—ＦＵ的作用时间，增强其抗肿瘤疗效。它的最佳适应症是局限于一叶的肝肿瘤。Objective: To study the change of the plasma concentration of 5-FU in primary liver cancer treated by transcatheter arterial chemoembolization with temporary hepatic venous occlusion (TACE-THVO), and the indication of TACE-THVO. Methods: 20 patients with different types primary hepatic cancer (PLC) were treated by TACE-THVO, 5 patients with massive-type tumor, 10 patients with nodular-type tumor, 5 with diffuse-type tumor. 15 patients with tumor located in the right hepatic lobe, 5 with diffuse tumor or invaded two lobes, 5 patients with hepatoarterio-venous shunting. The high performance liquid chromatograph (HPLC) was employed to measured the plasma concentration of 5-FU in the right hepatic vein, the entrance of the hepatic veins coming into inferior venae cava and the peripherial vein. Results: The average plasma concentration of 5-FU in right hepatic vein was higher than that in the other two locations and the duration of high concentration of 5-FU was longer. The average time for the high concentration of 5-FU in right hepatic vein was 15 minutes in patients with tumor located in the right hepatic lobe, and 7 minutes in patients with diffuse tumor or invaded two lobes. The time in patients without hepatoarterio-venous shunting was 14 minutes versus 5 minutes in patients with hepatoarterio - venous shunting. Conclusion: TACE-THVO can markedly increase the drug concentration of 5-FU within the tumor area, prolong its effective time and enchance its antitumor effectiveness. The best indication of TACE-THVO is tumor located in single hepatic lobe.

关 键 词：原发性肝癌 5-FU 肝动脉 肝静脉 血药浓度 

分 类 号：R735.705[医药卫生—肿瘤] R969.1[医药卫生—临床医学]