伊立替康经肝动脉栓塞化疗对不可切除肝癌患者生存期的影响  

CPT-11 transarterial chemoembolization prolongs survival of patients with unresectable hepatocellular carcinoma

作　　者：吴杰[1] 宋磊[1] 赵丹懿[1] 刘静[1] 郭冰[1] 

机构地区：[1]大连医科大学第二附属医院介入科,辽宁省116000

出　　处：《中华普通外科杂志》2014年第7期534-537,共4页Chinese Journal of General Surgery

基　　金：辽宁省科技局计划基金资助项目（2010225034）

摘　　要：目的 比较化疗药伊立替康（irinotecan,CPT-11）与表阿霉素传统化疗方案动脉灌注化疗栓塞术（transarterial chemoembolization,TACE）治疗不可切除的肝细胞癌（hepatocellular carcinoma,HCC）患者的生存情况.方法 83例确诊的患者行肝细胞癌动脉化疗栓塞术,分为CPT-11组和阿霉素组,其中CPT-11组24例,阿霉素类组59例.末次随访时间为2012年12月31日,采用KaplanMeier方法进行生存分析,Log-rank检验比较生存曲线差异.结果 CPT-11组的总生存期显著优于阿霉素组,分别为21.7,14.5个月（P =0.042）;2组患者无进展生存期比较,差异无统计学意义（P=0.091）,但CPT-11组无进展生存时间长于阿霉素组,分别为11.42及9.46个月.BCLC B分期亚组分析中,CPT-11组的无进展生存及总生存期具有优势（P=0.029及P=0.014）.2组患者的术后毒性反应差异无统计学意义（P＞0.05）.结论 将CPT-11应用到TACE中对于不可切除肝癌患者可以显著延长总生存期.Objective To study the efficacy of CPT-11 TACE in the treatment of unresectable HCC.Methods A retrospective review was undertaken on unresectable HCC patients receiving doxorubicin transarterial chemoembolization （59 cases） and irinotecan（CPT-11） in 24 cases from May 2003 to November 2011.Survival analysis was performed with Kaplan-Meier statistics.Differences in survival between the two groups were assessed for statistical significance with the log-rank test.Results Overall survival time was significantly longer in patients treated with CPT-11 compared with doxorubicin treated group （21.7 vs 14.5 months,P =0.042）.There was no significant difference in time to progression between the two groups,but time to progression was longer in CPT-11 group than doxorubicin treated group （11.42 vs 9.46 months,P =0.091）.Subgroup analysis showed that for intermediate-stage HCC,CPT-11 resulted in a significantly longer time to progression and overall survival compared with doxorubicin treated group （P =0.029 and P =0.014,respectively）.There were no significant differences in adverse events among the two groups （P ＞ 0.05）.Conclusions Chemotherapeutic agent CPT-11 in the form of TACE significantly improved overall survival when compared with doxorubicin for the treatment of unresectable HCC.

关 键 词：癌 肝细胞 化学栓塞 治疗性 抗肿瘤联合化疗方案 存活率 伊立替康 

分 类 号：R735.7[医药卫生—肿瘤]