不同化疗模式及不同给药途径对肝癌合并门静脉癌栓术后化疗作用的比较研究  

Comparison of different chemotherapeutic patterns and drug-administration ways after resection of hepatocellular carcinoma with tumor thrombi in portal vein

作　　者：樊嘉[1] 周俭[1] 吴志全[1] 邱双健[1] 陈荣新[1] 肖永胜[1] 汤钊猷[1] 

机构地区：[1]复旦大学肝癌研究所附属中山医院,上海市200032

出　　处：《中华肝胆外科杂志》2003年第6期334-337,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：上海市百人计划基金 ( 97BR0 2 9);上海市科技发展基金( 9844 190 67)

摘　　要：目的　比较研究不同化疗模式及不同给药途径对肝癌合并门静脉癌栓术后化疗作用及其疗效。方法　 5 6例肝癌合并门静脉癌栓手术切除病人 ,按术后化疗给药途径不同随机分为 :(1)未行化疗组 (n =18) ;(2 )门静脉置管 (PVI)化疗组 (n =19例 ) ;(3)PVI+肝动脉置管 (HAI)化疗组 (n =19例 ) ;按术后化疗模式不同随机分为 :(1)未行化疗组 (n =18) ;(2 )推注化疗组 (n =18例 ) ,其中 10例经PVI给药 ,8例经PVI +HAI给药 ;(3)持续灌注化疗组 (n =2 0例 ) ,其中 8例经PVI给药 ,12例经PVI +HAI给药。结果　PVI化疗组和PVI +HAI化疗组平均生存时间分别为 14个月和 17个月 ,两组比较无显著差异 (P >0 0 5 ) ,但均明显高于术后未化疗组 7个月 (P <0 0 5 )。推注化疗组和持续灌注化疗组的平均生存时间分别为 13个月和 19个月 ,两组比较有显著差异 (P <0 0 5 ) ,均明显高于未化疗组 (P <0 0 5 )。结论　肝癌合并门静脉癌栓术后经PVI化疗或经PVI +HAI化疗可明显提高疗效 ,而持续灌注化疗疗效明显优于推注化疗。Objective To compare the effects of different chemotherapeutic patterns and drug-administration ways on outcome of chemotherapy after resection of hepatocellular carcinoma (HCC) with tumor thrombi in portal vein (PVTT). Methods Fifty-six HCC patients with PVTT were randomly divided into 3 groups according to different ways of chemotherapy after operation: (1) no chemotherapy group (n=18). (2) Portal vein infusion (PVI) chemotherapy group (n=19). (3) PVI+hepatic artery infusion (HAI) chemotherapy group (n=19). Meanwhile, they were randomized into 3 groups based on chemotherapeutic patterns after the operation: (1) no chemotherapy group (n=18). (2) injection chemotherapy group (n=18). In this group, 10 patients received chemotherapy through PVI and other 8 through PVI-HAI. (3) Continuous infusion chemotherapy group (n=20). Of the patients, 8 received chemotherapy though PVI and the other 12 through PVI+HAI. Results The mean survival time of the patients in PVI chemotherapy group and PVI+HAI chemotherapy group was 14 and 17 months, respectively (P>0.05). The mean survival time of the patients in injection chemotherapy group and continuous infusion chemotherapy group was 13 and 19 months, respectively (P<0.05). It was significantly longer than that of patients in no chemotherapy group (P<0.05). Conclusions (1) The effect of chemotherapy through PVI is almost the same as that of the chemotherapy through PVI+HAI. (2) The effect of the continuous infusion chemotherapy through PVI or PVI+HAI is better than that of the injection chemotherapy.

关 键 词：肝癌 合并症 门静脉癌栓 化疗模式 给药途径 门静脉置管 肝动脉置管 

分 类 号：R735.7[医药卫生—肿瘤] R730.53[医药卫生—临床医学]