经肝动脉灌注利卡汀序贯联合TACE治疗不可切除肝细胞癌的近期疗效与安全性分析  

Safety and Short-Term Efficacy of Licartin Combined with cTACE in Unresectable HCC

作　　者：余子牛[1] 李家平[2] 卢鸣剑[2] 张岳林[1] 聂春晖[1] 董孟杰[1] 孙军辉[1] 

机构地区：[1]浙江大学医学院附属第一医院肝胆胰介入治疗中心,310003 [2]中山大学附属第一医院肿瘤介入科,510080

出　　处：《临床放射学杂志》2016年第6期929-933,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金项目(编号:81371658);广州市重大科技攻关计划项目(编号:201300000189);浙江省医药卫生科研项目(编号:2013KYB097)

摘　　要：目的探讨经肝动脉灌注利卡汀序贯联合经肝动脉化疗栓塞(TACE)治疗不可切除肝细胞癌的近期疗效与安全性。方法回顾分析接受利卡汀肝动脉灌注序贯联合常规TACE治疗的13例原发性肝癌患者资料,利卡汀肝动脉灌注剂量为27.75MBq/kg,常规TACE方案为吡柔比星和碘化油适量混合乳化行动脉化疗栓塞,并辅以适量聚乙烯醇颗粒强化栓塞。结果根据mRECIST评价标准,治疗后1个月的疾病缓解率达到69.3%,疾病控制率则为100%;3个月疾病缓解率为69.3%,疾病控制率为84.6%;6个月疾病缓解率为61.5%,疾病控制率为76.9%;9个月的疾病缓解率和疾病控制率分别为60%和80%。治疗后6个月生存率达到100%,1年、2年预测生存率分别为68%、45%。术后1个月患者肝肾功能、血象等指标同术前相比无统计学意义,所有患者均未出现严重感染、黄疸、消化道出血及骨髓抑制等并发症。结论经肝动脉灌注利卡汀序贯联合TACE治疗不可切除肝细胞癌具有较好的近期疾病缓解率、疾病控制率与良好的安全性。Objective To evaluate the safety and short-term efficacy of Licartin combined with conventional TACE in treatment of patients with unresectable hepatocellular carcinoma.Methods From January 2012 to December 2014,13 patients with unresectable primary liver cancer treated by Licartin combined with conventional TACE in our hospital were retrospectively analyzed.Licartin infused by hepatic arterial route at a dose of 27.75 MBq / kg prior to conventional TACE（pirarubicin 20 mg and certain iodized oil）,supplemented by a certain amount of poly vinyl alcohol（ PVA） particles to strengthen embolic effect.Results According to mRECIST evaluation criteria,the disease remission rates and disease control ratesafter 1,3,6,9 months were 69.3% and 100%; 69.3% and 84.6%; 61.5% and 76.9%; 60% and 80%respectively.The survival rate was 100% after 6 months,whilst 1 year and 2 year survival rates as estimated by Life Tables were 68% and 45% respectively.Liver and kidney function showed no significant difference pre-and post-treatment,no serious infections,jaundice,gastrointestinal bleeding and bone marrow suppression was observed in all patients.Conclusion Licartin combined with conventional TACE showed a good short-term efficacy and less side effects in patients with unresectable primary liver cancer,while long-term efficacy required long-term follow-up in large cohort.

关 键 词：利卡汀 肝动脉化疗栓塞 原发性肝癌 131I美妥昔单抗 

分 类 号：R735.7[医药卫生—肿瘤]