药敏实验指导的区域化疗对不能手术切除肝癌的治疗作用  

Sensitivity test-guided area chemotherapy for unresectable primary liver cancer

作　　者：吴东德[1,2] 夏晓勤[2] 刘宝珍[3] 袁玉峰[1] 刘志苏[1] 

机构地区：[1]武汉大学中南医院肝胆胰外科,武汉430071 [2]湖北省肿瘤医院肝胆胰科 [3]武汉纺织大学

出　　处：《中华实验外科杂志》2013年第3期621-623,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨区域灌注依据药敏实验选择的化疗药物对不能手术切除的肝癌患者的疗效。方法120例不能手术切除的原发性肝癌患者随机分组，实验组按药敏实验选择化疗药经肝动脉／门静脉化疗泵输入，对照组经肝动脉栓塞化疗。对比两组患者的肿瘤反应率、甲胎蛋白（AFP）变化、并发症、二期手术切除率和生存时间。结果实验组肿瘤缩小或稳定分别为28、14例，对照组为17、7例。实验组AFP下降为51例而对照组为30例（P〈0．05）。实验组中位随访21个月，6、12、18个月无进展生存率（PFS）及总生存期（OS）分别为：78％、70％、65％和86％、72％、65％，优于对照组（P〈0．05），实验组的化疗不良反应较对照组低（P〈0．01）。结论药敏指导不能手术切除的原发性肝癌区域灌注化疗可延长生存时间并降低并发症发生率。Objective To evaluate the effectiveness of sensitivity test-guided area-perfusion chem- otherapy for unresectable primary liver cancer. Methods 120 cases of human liver cancer were divided in- to two groups at random： experimental group and control group. Guided by the results of drug sensitivity test, 3 drugs were chosen and transfused from the liver artery and portal vein pump in the experimental group. The 60 patients in the controI group were subjected to transarterial chemoembolization（TACE）. The tumor size, levels of alpha fetal protein （AFP）, two-step operation rate, survival rate, and complications were compared between two groups. Results The tumor size measured by CT or MRI was ruduced in 28 （47.6%） cases, or stable ~n 14 （23.3%） cases in experimental group after six courses of chemotherapy, and 17 （28.5%） cases and 7 （ 11.5% ） cases in the control group （P 〈0. 05）. The AFP level was de- clined in 51 cases of experimental group, while in 30 cases of control group （P 〈 0. 05 ）. In experimental group, the median follow-up time was 21 months, the progression-free survival （PFS） and overall survival （OS） ratio at 6th, 12th, and 18th month was 78% , 70%, 65% and 86%, 72% , and 65% respectively, which were superior to those in control group （P 〈 0. 05 ）. The incidence of complications in experimental group was lower than in control group （P 〈 O. O1 ）. Conclusion The artery and portal vein pump transfu- sion chemotherapy guided by drug Sensitivity test-guided area-perfusion chemotherapy for unresectable pri- mary liver cancer can prelong PFS and OS, and reduce the incidence of complication.

关 键 词：原发性肝癌 药敏实验 区域化疗 

分 类 号：R735.7[医药卫生—肿瘤]