三氧化二砷联合经皮肝动脉插管化疗栓塞治疗原发性肝癌肺转移的临床疗效观察  

Clinical observation on arsenic trioxide combined with transcatheter arterial chemoembolization in treatment of patients with primary liver cancer and lung metastasis

作　　者：郑盛 李林[2] 

机构地区：[1]云南省第三人民医院消化内科,昆明650011 [2]广东省人民医院肿瘤防治中心,广州510080

出　　处：《中国肝脏病杂志（电子版）》2013年第2期27-30,共4页Chinese Journal of Liver Diseases：Electronic Version

摘　　要：目的探讨三氧化二砷(As2O3)联合经皮肝动脉插管化疗栓塞对原发性肝癌肺转移患者的治疗效果。方法选择64例原发性肝癌肺转移患者随机分为治疗组(30例)和对照组(34例)。治疗组针对肝脏原发病灶行周期性经皮肝动脉插管化疗栓塞术(TACE),TACE3天后给予As2O3持续静脉滴注5小时(10mg/d,14天为1个疗程),疗程间隔2周,连续进行3～4个疗程。对照组仅针对肝脏原发性病灶行周期性TACE。观察两组患者的客观有效率、获益率、生活质量等指标及转移瘤大小、灶数与疗效的相关性。结果治疗组患者客观有效率为26.7%(8/30),获益率为60.0%(18/30);对照组客观有效率为0(0/34),获益率为17.6%(6/34),两组患者客观有效率及获益率差异均有统计学意义(χ2=7.067,P=0.008;χ2=11.915,P=0.001)。治疗组生活质量改善4例,稳定18例;对照组改善0例,稳定13例,两组生活质量改善及稳定情况差异有统计学意义(χ2=9.669,P=0.008)。肿瘤负荷与疗效呈显著负相关,且关系密切(Kendall相关系数为-0.765,P<0.001;Spearman相关系数为-0.821,P<0.001)。结论 As2O3联合动脉化疗栓塞是一种治疗原发性肝癌肺转移的有效治疗方法。Objective To observe the therapeutic effects of arsenic trioxide combined with transcatheter arterial chemoembolization in treatment of primary liver cancer and pulmonary metastases. Methods Total of 64 patients were randomly divided into treatment group （n = 30） and control group （n = 34）. treatment group received periodic transcatheter arterial chemoembolization （TACE） and 10 mg arsenic trioxide by intravenous infusion for 5 hours per day, 3 days after TACE. Each cycle of treatment persisted for 14 days with a interval of 2 weeks and 3-4 cycles were administered continuously. Patients in control group received periodic TACE merely. Objective efficiency, benefit rate, quality of life and the correlationship with metastatic tumor size and number in both groups were recorded. Results The objective efficiency was 26.7% （8/30）, and the benefit rate was 60.0 （18/30） in treatment group, while 0 （0/34） and 17.6% （6/34） in control group respectively, with significant statistical differences （＆chi; 2 = 7.067, P = 0.008; ＆chi; 2 = 11.915, P = 0.001）. The quality of life was improved in 4 patients and stable in 18 cases in treatment group, while no patient was improved and 13 were stable in control group （＆chi; 2 = 9.669, P = 0.008）. There was a significantly positive correlationship between the tumor burden and therapeutic effect （Kendall r = -0.765, P 〈 0.001; Spearman r = -0.821, P 〈 0.001）. Conclusions Arsenic trioxide combined with TACE is an effective treatment method in treatiment of primary liver cancer and pulmonary metastases.

关 键 词：肝肿瘤 砷剂 肿瘤负荷 插管法 肝动脉 

分 类 号：R735.7[医药卫生—肿瘤]