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1.
评价肝动脉化疗栓塞合并LAK/IL┐2灌注治疗原发性肝癌的初步疗效。方法不能切除的肝癌患者经肝动脉化疗栓塞后灌注自体LAK细胞及IL┐2,并与单独行肝动脉化疗栓塞的不能切除肝癌患者比较其肿瘤大小,生活质量的变化及毒副反应。结果经肝动脉化疗栓塞合并LAK/IL┐2灌注治疗的22例肝癌有效率(CR+PR)为13.6%,包括1例完全缓解和2例部分缓解,而单独化疗栓塞对照组17例中仅1例显示部分缓解(有效率5.9%)。化疗栓塞+LAK/IL┐2治疗组与单独化疗栓塞对照组中MR、SD、PD分别为5、12、1例和1、11、4例。治疗组中大多数病人生活质量改善或稳定,而对照组中生活质量则无提高。两组病人的毒副反应均较轻而短暂。结论经肝动脉化疗栓塞合并LAK/IL┐2灌注治疗原发性肝癌疗效较优于单独肝动脉化疗栓塞治疗,原发性肝癌更有效的综合治疗方案有待进一步探索  相似文献   

2.
我院1993年4月至6月经肝动脉及门静脉安置的植入式微泵,输注自体LAK细胞/IL-2及化疗药物治疗7例中晚期肝癌(其中2倒置泵,同时进行了肿瘤姑息性切除),近期疗效CR2例,PR3例,mR1例,PD1例,总有效率达85.7%,且毒性反应轻微。结果提示:对于中晚期肝癌,经肝动脉门静脉输注自体LAK细胞/IL-2及化疗药物,是一种极有前途的治疗措施,可望明显提高肝癌疗效。  相似文献   

3.
CD3AK细胞和LAK细胞治疗晚期恶性肿瘤的临床和实验研究   总被引:3,自引:0,他引:3  
将51例晚期恶性肿瘤患者(男性23例,女性28例)分成两组,其中一组(31例)以CD3McAb(CD3单克隆抗体)和小剂量IL-2(500u/ml)共同诱导的CD3AK细胞治疗,另一组(20例)输注大剂量IL-2(1000u/ml)诱导的常规LAK细胞治疗,以探讨降低IL-2用量、提高杀伤细胞细胞毒活性的可能性。结果显示CD3AK组患者生活质量改善、症状缓解均优于LAK组。CD3AK组PR+MR率较LAK组高29.0%,S+P率和死亡率分别较LAK组低12.4%和9.6%。同时比较了CD3AK细胞与LAK细胞的体外增殖和细胞毒活性,结果表明CD3AK细胞增殖率高于LAK细胞(P<0.01),靶细胞抑制率二者在0.05水平无显著差异。提示CD3McAb在刺激杀伤细胞活性,尤其在提高其增殖能力方面,具有显著的作用,CD3AK/IL-2能更有效地治疗晚期恶性肿瘤。  相似文献   

4.
本文对32例原发性肝癌经腹肝动脉插管,使用碘油抗癌药物乳化液栓塞治疗,与48例原发性肝癌行姑息性切除术进行比较分析。结果:栓塞化疗组与姑切组的AFP转阴率、1年生存率、2年生存率分别为:82.7%(24/29)与0,62.5%(20/32)与20.1%(10/48),32.0%(8/25)与0(P<0.05)。且栓塞化疗组3例获Ⅱ期根治性切除术.1例带瘤生存54个月,至今健在。提示:对不能行根治性切除的肝癌,选用肝动脉插管栓塞化疗为佳。  相似文献   

5.
为研究1 种新的过继免疫化疗治疗肝癌的方法,采用肝癌细胞株H22 接种于近交系Balb/c 小鼠皮下,制成肿瘤模型。使用IL2 、肿瘤活化的杀伤细胞(AK细胞)及环磷酰胺(Cy) 进行治疗,检测小鼠脾淋巴细胞NK、LAK及CTL 活性,用流式细胞仪检测L3T4 亚群及Lyt2 亚群含量。结果表明在过继免疫化疗组小鼠LAK 及CTL活性明显高于其它治疗组(P< 0.01),荷瘤小鼠肿瘤结节生长较IL2 组及Cy 组明显缓慢(P< 0.01),生存期也明显高于其它各治疗组(P<0 .01)。该研究表明过继免疫化疗有较强的抗肿瘤作用。  相似文献   

6.
枸杞多糖联合LAK/IL-2疗法对75例晚期肿瘤的疗效观察   总被引:1,自引:0,他引:1  
用枸杞多糖(LyciumBarbarumPolysaccharides,LBP)联合LAK/IL-2疗法临床试验治疗79例晚期肿瘤患者,其中75例可评估病人资料分析提示,LBP联合LAK/IL-2疗法组疗效(40.9%)显著优于LAK/IL-2疗法组(16.1%)。两种治疗方案对恶性黑色素瘤、肾癌、直结肠癌、肺癌、恶性胸水和鼻咽癌有一定的疗效。LBP联合LAK/IL-2治疗组的缓解持续时间显著长于LAK/IL-2治疗组。LBP联合LAK/IL-2治疗组治疗前后外周血淋巴细胞(PBL)的NK、LAK活性增高程度均显著大于LAK/IL-2治疗组,说明LBP能够提高LAK/IL-2疗法对晚期肿瘤的治疗效果。  相似文献   

7.
枸杞多糖联合LAK/IL—2疗法对75例晚期肿瘤的疗效观察   总被引:6,自引:0,他引:6  
用枸杞多糖(LBP)联合LAK/IL-2疗法临床试验治疗79例晚期肿瘤患者,其中75例可评估病人资料分析提示,LBP联合LAK/IL-2疗法组疗效(40.9%)显著优于LAK/IL-2疗法组(16.1%)。两种治疗方案对恶性黑色素瘤、肾癌、直结肠癌、肺癌、恶性胸水和鼻咽癌有一定的疗效。LBP联合LAK/IL-2治疗组的缓解持续时间显著长于LAK/IL-2治疗组。LBP联合LAK/IL-2治疗组治疗  相似文献   

8.
罗慧玲  蔡体育  陈巧伦  黄民权  梅承恩  李永强 《癌症》2000,19(12):1124-1126
目的:探讨石斛多糖(dendrobium candidum polysaccharide,DCP)与rIL-2联合应用对脐带血LAK细胞(CB-LAK)和肿瘤病人外周血LAK细胞(PB-LAK)体外杀伤肿瘤细胞作用的影响。方法:应用^3H-TdR释放法测定CB-LAK和PB-LAK细胞的杀伤活性。结果:①rIL-2(500u/ml)能明显提高CB-LAK对Raji细胞的杀伤活性,0h的CB-LAK活性为13.63%,rIL-2(500u/ml)诱导48、72、96、120h后,CB-LAK活性分别提高至22.28%、26.23%、28.55%和25.76%(P〈0.01);②DCP(100mg/L或400mg/L)与rIL-2(500u/ml)联合诱导CB-LAK的活性,比单纯rIL-2(500u/ml)的作用  相似文献   

9.
作者以皮下接种人肝细胞癌细胞SMMC7721的裸鼠为荷瘤模型,由人外周血单个核细胞经体外IL-2和丝裂霉素C灭活的人肝癌细胞SMMC7721共同刺激培养后激活的杀伤细胞(AK),研究了将成纤维细胞介导的人IFN-α基因疗法与IL-2/AK/阿霉素过继免疫化疗联合应用后对肝癌的治疗作用。结果表明:(1)给肝癌裸鼠单独腹腔埋植人IFN-α基因转移的NIH3T3成纤维细胞(NIH3T3-IFN-α ̄+)就能显著抑制肝癌(皮下)体内生长,使荷瘤裸鼠存活期明显延长;(2)在腹腔埋植NIH3T3-IFN-α ̄+之后再静脉注射AK细胞、腹腔内注射IL-2,发现荷瘤裸鼠的皮下肿瘤结节生长抑制作用更明显;(3)将NIH3T3-IFN-α ̄+与IL-2/AK/阿霉素联合应用后,对肝癌裸鼠的治疗效果更佳。  相似文献   

10.
采用淋巴因子诱导的细胞毒细胞(LICC)和IL—2/LAK细胞治疗32例晚期恶性肿瘤患者,LICC治疗20例,IL—2/LAK治疗12例,结果发现68.8%(22/32)卡氏得分上升,多数患者癌性症状减轻,生活质量提高,以LICC组优于LAK组,CR+PR+MR率,LICC为40.0%(12/20),LAK组为16.7%(2/12)。作者认为过继免疫作为一种癌症辅助治疗方法应予肯定;LICC治疗安全、副反应小,抗瘤谱广,费用低,疗效优于IL—2/LAK,值得扩大应用性研究。  相似文献   

11.
小肝癌切缘复发预防及临床处理方法的探讨   总被引:5,自引:2,他引:3  
Fang WQ  Li SP  Zhang CQ  Xu L  Shi M  Chen MS  Li JQ 《癌症》2005,24(7):834-836
背景与目的随着医疗诊断技术的提高,越来越多的小肝癌被发现,目前治疗小肝癌首选的方法仍是手术切除,但其术后复发率高达60%以上。本研究中我们对临床小肝癌进行回顾对照分析,拟探讨降低小肝癌手术切缘复发率的方法。方法回顾性分析广东省开平市中心医院和中山大学肿瘤医院在1991年1月~2003年5月间收治的283例小肝癌患者的临床病理资料。由于85%以上的肝癌患者合并不同程度肝硬化和肝储备功能不良,故以非规则性肝切除术为主。其中作肿瘤剔出术加残端切缘注射无水乙醇或无水乙醇明胶海绵创面填塞术140例(研究组);143例仅作普通常规处理(对照组)。比较两组患者的年龄、性别、肿瘤部位、肿瘤分期、Child-Pugh分期无统计学意义。结果研究组和对照组切缘1年复发率分别为21.4%和4.4%,有显著性差异(P<0.05);肝内转移/再发率分别为26.1%和24.5%,无统计学意义(P>0.05)。研究组和对照组5年总生存率分别为57.3%、52.8%(P=0.48),5年无瘤生存率分别为35.2%、36.9%(P=0.51)。两组患者术后一周内体温均在39℃以下;均无明显白细胞升高、胆漏及出血出现。结论不规则肝切除术后残端用无水乙醇明胶海绵填塞,或在残端处注射无水乙醇,对减少术后残端局部复发有一定效果,但对术后转移复发再发无作用,此法简单经济实用,便于推广应用,副作用少。  相似文献   

12.
Tono T  Hasuike Y  Ohzato H  Takatsuka Y  Kikkawa N 《Cancer》2000,88(7):1549-1556
BACKGROUND: Greater than 50% of patients who undergo curative resection of liver metastases from colorectal carcinoma develop recurrent disease in the residual liver. Although several studies have attempted to use hepatic arterial infusion (HAI) chemotherapy to prevent recurrence, to the authors' knowledge the efficacy of the treatment has not yet been determined. METHODS: Nineteen patients who underwent curative hepatectomy for metastatic colorectal carcinoma randomly were assigned into the HAI group (nine patients) or the control group (ten patients). Patients in the HAI group received continuous intraarterial infusion of 5-fluorouracil (5-FU) (500 mg/day) for 4 days followed by a 3-day rest. The treatment was continued for 6 weeks. RESULTS: The median follow-up period was 62.2 months. The recurrence was confirmed in three patients in the HAI group and in eight patients in the control group. Of these, recurrence in the remnant liver was observed in one patient and in six patients, respectively. The median disease free interval after hepatectomy was 62.6 months in the HAI group and 13.8 months in the control group. The 1-year, 2-year, and 3-year disease free survival rates were 77.8%, 77.8%, and 66.7%, respectively, in the HAI group and 50.0%, 30.0%, and 20.0%, respectively, in the control group. Significant prolongation of disease free survival was observed in the HAI group (P = 0.045). No patients in the HAI group reported any adverse effect of >/= Grade 2 (according to the National Cancer Institute Common Toxicity Criteria). Two patients in the HAI group and five patients in the control group were dead of disease at the time of last follow-up. The 1-year, 3-year, and 5-year cumulative survival rates for the HAI group were 88.9%, 77.8%, and 77.8%, respectively, whereas those of the control group were 100.0%, 50.0%, and 50.0%, respectively (P = 0.2686). CONCLUSIONS: This randomized study revealed that short term HAI of 5-FU after curative resection of colorectal hepatic metastases is effective in preventing the recurrence of disease without any serious complications.  相似文献   

13.
Four hundred and ten patients with colorectal liver metastases underwent radical liver resection from 1992 to 1996 at 15 institutes were reviewed retrospectively. Survival rates were calculated for more than 5 years after hepatic resection and timing of surgery and recurrences, maximum diameter and number of liver metastases, and intrahepatic recurrence were examined. There was no significant difference in survival rates for the type of liver resection (partial or anatomical) or preoperative serum CEA levels. As for the number of metastases, the 5-year survival rate was lower for patients with over 4 metastases than those with 1, 2, and 3 metastases (p < 0.034). A significant difference in survival rates was recognized for size of liver metastases (p = 0.0309) as follows: 54.6% 5-year survival rate for smaller than 4 cm and 43.8% for over 4 cm. Overall 5-year survival rate for the 410 patients was 50.1% after radical hepatectomy. Of the 410 patients, the 153 (37.3%) patients with intrahepatic recurrence had a 5-year survival rate of 27.3%. The 5-year survival rates for patients with a metastasis smaller than 4 cm, considered to reduce the influence in the difference between surgical procedure or indication for surgery, were verified to be from 88.2% to 11.9% in each institute. This suggests that there could be a difference in diagnostic accuracy, surgical indication or timing of surgery for synchronous liver metastases in each institute.  相似文献   

14.
以外科手术为主综合治疗小肝癌134例临床报告   总被引:5,自引:1,他引:4  
Mo QG  Liang AM  Yang NW  Zhao YN  Yuan WP 《癌症》2003,22(2):189-191
背景与目的:手术切除是治疗小肝癌的首选方法,但术后5年复发率高达35.4%-45.3%,是影响手术疗效的关键因素。本研究拟探讨以外科为主的综合治疗来降低小肝癌术后复发率。方法:以外科为主综合治疗小肝癌(直径≤5cm)患者134例,男119例,女15例,年龄18-70岁,中位年龄45岁;手术切除(切除组)121例,其中,不规则性肝叶切除16例,局部切除83例,肝叶或肝段切除12例,左半肝切除2例,联合胆吓切除8例;切除后切缘注射无水酒精或用渗入无水酒精的明胶海绵包埋于瘤床共22例。手术不能切除13例,行肝固有动脉结扎合并肝动脉及门静脉双插管化疗或瘤体内注射无水酒精或冷冻、射频治疗、微波固化、栓塞化疗等。结果:小肝癌手术切除率90.3%,无手术死亡。切除组术后1、3、5、10年生存率分别为89.3%、74.4%、64.6%和43.8%;术后1、3、5年复发率分别为11.9%、23.8%和32.1%。全组1、3、5、10年生存率分别为88.8%、72.2%、63.4%和41.7%;1、3、5年复发率分别为15.9%、29.1%和36.6%。结论:手术切除是治疗小肝癌的有效方法,以个体化为原则外科为主的综合治疗可降低术后复发率,提高小肝癌治疗效果。  相似文献   

15.
BACKGROUND: The impact of the use of preoperative portal vein embolization (PVE) on long-term survival after surgery was evaluated by retrospective analysis of prognostic factors in patients with advanced-stage hepatocellular carcinoma (HCC) who had undergone hepatic resection with or without PVE. METHODS: The portal embolization group (Group P) consisted of 26 patients who had undergone major hepatectomy (more extensive than right hepatectomy) with PVE, and the nonembolized group (Group N) consisted of 43 patients who had undergone major hepatectomy without PVE. All patients were diagnosed with advanced HCC graded as Stage III or IV according to the International Union Against Cancer TNM classification system. Patient survival rates, recurrence rates, and recurrence sites after surgery in the two groups were evaluated and compared. RESULTS: The 1-year, 3-year, and 5-year cumulative disease specific survival rates in patients with TNM Stage III HCC, respectively, were 96.0%, 64.4%, and 52.7% in Group N and 92.9%, 57.1%, and 45.7% in Group P, whereas the corresponding values in patients with Stage IV HCC were 53.5%, 40.1%, and 26.8% in Group N and 63.5%, 50.8%, and 19.1% in Group P. There were no statistically significant differences in survival rates between Group P and Group N. Multivariate analysis showed that PVE was not a significant prognostic factor. The 1-year, 3-year, and 5-year cumulative recurrence rates for patients with both stages of disease combined were 44.1%, 80.2%, and 86.8% in Group N, respectively, and 39.9%, 72.2%, and 72.2% in Group P, respectively, with no statistically significant differences between the two groups. To date, 35 patients in Group N and 16 patients in Group P have had tumor recurrences in the liver remnant; of these, 27 patients in Group N and 12 patients in Group P had multiple recurrence foci in the liver remnant. No significant difference was seen between the two groups; however, 10 of 16 patients in Group P (62.5%) had remote organ metastasis in addition to recurrence in the liver remnant compared with only 6 of 35 patients in Group N (17.1%): This difference was significant statistically (P = 0.012). CONCLUSIONS: PVE during major hepatic resection neither improves nor worsens long-term prognosis but allows resection in a patient group that, otherwise, is considered as unresectable. Remote metastasis involving the lung, bone, or stomach was seen more frequently postoperatively in Group P compared with Group N, raising a possibly important issue regarding the use of this approach for the treatment of patients with hepatic malignancies, especially HCC.  相似文献   

16.
目的 探讨直肠癌局限性肝转移的手术及术后经门静脉途径灌注化疗的安全性和有效性。方法 对40例直肠癌局限性肝转移患者行手术治疗,其中同时性肝转移患者18例行同时性手术。术后随机分组行前瞻性对照研究,A组22例行门静脉途径灌注化疗,B组18例行周围静脉化疗,随访观察治疗效果。结果 所有病人均安全度过围手术期,无严重并发症,A组术后生存率和复发率均优于B组,差异有统计学意义〔P<0.05〕。结论 直肠癌局限性肝转移行手术治疗效果好;直肠癌同时性肝转移者采用同时性手术是安全可行的;术后经门静脉途径化疗可进一步提高疗效。  相似文献   

17.
目的探讨降低原发性肝癌切除术后局部复发的方法,提高肝癌患者的长期生存率。方法78例肿瘤靠近第一、第二肝门,估计切缘距肿瘤<1cm的肝癌患者,按就诊单双日分为单纯切除组和联合组。单纯切除组38例,仅行常规肝癌切除;联合组40例,在肝癌切除后,切缘行射频消融和~(125)I粒子植入。全部患者术后均定期随访。结果联合组术后1、3、5年肿瘤复发率分别为7.5%、30.0%和45.0%,术后1、3、5年生存率分别为92.5%、67.5%和30.0%,与单纯切除组比较,其中3、5年复发率差异有统计学意义((x~2=7.340,P<0.01;x~2=15.740,P<0.01);联合组的3、5年生存率较单纯切除组呈现明显升高的趋势。结论肝癌切除后切缘射频消融和~(125)I粒子植入能有效地降低术后局部复发率,提高治疗效果,且有可能延长肝癌患者的生存期。  相似文献   

18.
Hepatectomy may be the only treatment modality for the cure of colorectal liver metastasis. However, whether to perform nonanatomical resection or anatomical resection remains unclear. Original articles in English on liver metastasis, including reports that dealt with case series of more than 50 curative hepatectomies, were reviewed, and the current status of surgical treatment for colorectal liver metastasis was summarized, with a special emphasis on the relevance, indications, and outcomes of anatomical hepatectomy. Anatomical hepatic resection was performed in 63% of the patients. For patients who were treated by curative hepatectomy, including both anatomical and nonanatomical resection, the morbidity rates, mortality rates, 5-year survival rates, and rates of hepatic recurrence were 23%, 3.3%, 34%, and 41.2%, respectively. In 73 articles that each analyzed more than 50 patients treated with potentially curative hepatectomy, the incidence of anatomical resection exceeded 50% in 56 series, while anatomical resection was performed in fewer than 50% of the patients in 17 series. A comparison between these two groups naturally revealed a remarkable difference in the incidence of anatomical resection (72% versus 34%), but no difference in terms of morbidity; mortality; survival rates at 3, 5, and 10 years; or rate of hepatic recurrence. The profile of liver metastasis related to prognosis was generally advantageous to patients treated with nonanatomical resection, and this may have nullified the survival advantage of anatomical hepatectomy over nonanatomical resection. Anatomical resection provides a higher probability of coresecting microscopic invasions that are predictable but undetectable, and can be recommended as a standard procedure for locally advanced metastatic liver cancer.  相似文献   

19.
目的:比较射频消融(RFA)与手术切除治疗直径3~5 cm肝癌的临床疗效和预后。方法:选取2014年1月至2016年12月我院收治的124例肝癌患者,其中行手术切除者64例(手术组),行RFA治疗60例(射频组),运用倾向性评分匹配,得到组间一般资料均衡的样本,对新样本进行并发症、住院时间和预后的比较。结果:两组患者共42对匹配。两组患者均未出现围手术期死亡病例。手术组术后总并发症的发生率和住院时间高于对照组,差异均有统计学意义(P<0.05)。手术组1年、2年和3年的总生存率为92.9%、73.8%和60.2%,射频组1年、2年和3年的总生存率为95.2%、75.9%和55.0%,两组比较差异无统计学意义(P=0.931)。手术组1年、2年和3年的无瘤生存率为71.4%、50.0%和34.7%,射频组1年、2年和3年的无瘤生存率为73.8%、50.0%和32.1%,两组比较差异无统计学意义(P=0.907)。结论:对于直径3~5 cm肝癌患者而言,RFA与手术切除疗效相当,且RFA创伤更小、并发症少、恢复更快。  相似文献   

20.
微波肝切除治疗肝癌的远期疗效   总被引:2,自引:0,他引:2  
目的研究微波肝切除治疗肝癌的远期疗效。方法54例原发性肝癌因严重肝硬化或肝脏萎缩行微波肝切除,以308例原发性肝癌手术根治性切除作对照。结果微波组术后一、三、五年生存率分别为905%、688%、547%;有14例(259%)复发,术后一、三、五年复发率分别为48%、280%、481%。微波组合并严重肝硬化、肿瘤包膜不完整者多(P<001),但与根治性切除组的远期疗效无显著性差异(P>005)。结论微波肝切除使部分合并严重肝硬化的肝癌患者获得肿瘤切除机会,并可能取得与根治性切除同样好的远期疗效  相似文献   

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