TACE术中灌注氟尿嘧啶、奥沙利铂及吡柔比星治疗原发性肝癌的临床效果分析  

TACE with infusion of fluorouracil, oxaliplatin and pirarubicin for the treatment of primary liver cancer: analysis of clinical effect

作　　者：乔彬彬[1] 虞希祥[1] 王舒婷[1] 郑冰汝 朱国庆[1] 施振静[1] 

机构地区：[1]温州医科大学附属第三医院介入科,浙江省温州市325200

出　　处：《介入放射学杂志》2015年第4期349-353,共5页Journal of Interventional Radiology

摘　　要：目的观察评价肝动脉化疗栓塞(TACE)联合灌注奥沙利铂(OXA)、氟尿嘧啶(5-Fu)及吡柔比星(THP)方案治疗原发性肝癌的疗效和安全性。方法回顾分析采用TACE术中动脉灌注OXA/5-Fu/THP化疗药物治疗的原发性肝癌患者65例,及同期行单纯肝动脉栓塞(TAE)治疗的原发性肝癌患者21例,分为TACE组和TAE组。对TACE灌注OXA/5-Fu/THP的疗效、不良反应发生率、无进展生存时间(PFS)及总生存期(OS)进行综合评价,并与单纯肝动脉栓塞进行对比分析研究。结果 TACE联合OXA/5-Fu/THP治疗的65例患者中,客观缓解率(ORR)55.4%,疾病控制率(DCR)81.5%;患者的中位PFS时间为11.5个月,中位OS时间为18.5个月;单因素分析中,Child-Pugh A级、无门脉癌栓、无肿瘤转移、肿瘤直径小及TACE治疗次数多的患者预后较好,差异有统计学意义(P<0.05);巴塞罗那分期(BCLC)B期的患者预后优于C期的患者,差异有统计学意义(P=0.000);Cox多因素分析中门脉癌栓及肿瘤远处转移是患者预后的独立危险因素。与单纯TAE相比,TACE联合OXA/5-Fu/THP可提高患者的m PFS。结论 TACE术中动脉灌注OXA/5-Fu/THP治疗原发性肝癌的疗效较好,不良反应少。Objective To evaluate the clinical efficacy and safety of transcatheter arterial chemoembolization（TACE） with oxaliplatin（OXA）, fluorouracil（5- Fu） and pirarubicin（THP） scheme in treating primary liver cancer. Methods A total of 65 patients with primary liver cancer were treated with TACE using infusion of OXA/5- Fu/THP scheme（TACE group）. Other 21 patients with primary liver cancer,who were encountered at the Department of Interventional Radiology of authors＇ hospital during the same period as the patients of TACE group, received simple transarterial embolization（TAE group）. The therapeutic effect, the occurrence of adverse reactions, the progression- free survival time（PFS） and overall survival time（OS） of the two groups were comprehensively evaluated. The results were compared between the two groups.Results In the TACE group, the objective response rate（ORR） and disease control rate（DCR） were 55.4%and 81.5% respectively, and the median PFS and median OS were 11.5 months and 18.5 months respectively.Single factor analysis indicated that patients, who had liver function of Child- Pugh A and received more times or treatment, and who had small- sized tumor and no portal vein tumor thrombus or metastasis, usually had a better prognosis, and the differences were statistically significant（P〈0.05）. The prognosis of the patients with Barcelona staging（BCLC） B was better than that of the patients with Barcelona staging C, and the difference was statistically significant（P=0.000）. Cox multivariate analysis revealed that the portal vein tumor thrombus and tumor metastasis were independent risk factors for the prognosis of the patients. Compared with the TAE group, TACE with OXA/5- Fu/THP scheme could effectively improve the mean progression- free survival time.Conclusion For the treatment of primary liver cancer, TACE with infusion of OXA/5- Fu/THP is clinically effective with fewer adverse reactions.

关 键 词：原发性肝癌 肝动脉化疗栓塞术 肝动脉栓塞术 吡柔比星 奥沙利铂 氟尿嘧啶 

分 类 号：R735.7[医药卫生—肿瘤]