多柔比星载药微球经导管动脉化疗栓塞治疗肝癌临床疗效观察

摘 要 目的：观察多柔比星载药微球治疗肝癌患者的临床疗效及安全性。方法: 129例无手术切除指征肝癌患者随机分为观察组（DCB TACE）60例和对照组（cTACE）69例。观察组给予装载50 mg多柔比星的载药微球（直径150~400μm）肝动脉化疗栓塞（TACE）治疗;对照组给予装载40~60 mg多柔比星的5~10 ml传统碘化油混合乳剂TACE治疗。两周进行一次治疗,3个月后观察肿瘤疾病进展情况。结果:观察组完全缓解率为55.0%,显著高于对照组的23.1%（P<0.001）。观察组患者的肿瘤进展时间和存活率均显著优于对照组（P＜0.05）; 两组药品不良反应发生率比较,差异无统计学意义（P>0.05）。结论:多柔比星载药微球可显著延长肝癌进展期、不良反应轻度,临床应用前景广阔。     

动脉栓塞微球的研究进展

动脉栓塞是指将栓塞剂选择性地注入病变靶区供血动脉,有效阻断血流,以达到预定治疗目的的技术,治疗恶性肿瘤效果显著。微球作为栓塞剂的治疗结果更加安全有效,它具有独特的球形外观和良好的栓塞性能,是目前最常用的栓塞剂。现按照基质的不同对栓塞微球进行分类,对动脉栓塞微球研究进展进行总结,着重介绍了各类栓塞微球的基础研究和临床应用状况,并探讨了栓塞微球的发展趋势。     

载药微球肝动脉化疗栓塞与基于碘化油经动脉化疗栓塞治疗消化系统肝转移瘤的临床分析

目的：探讨载药微球肝动脉化疗栓塞(DEB-TACE)与基于碘化油经动脉化疗栓塞(cTACE)治疗消化系统肿瘤肝转移的临床疗效。方法：选取2017年3月—2021年10月无法手术的消化系统肝转移瘤患者42例,根据治疗方案分为微球组(16例)和碘化油组(26例)。比较两组术后的客观缓解率(ORR)、疾病控制率(DCR)、不良反应情况及肝功能变化。结果：微球组的ORR及DCR分别为56.3%和87.5%,高于碘化油组的19.2%和57.7%;术后1周,碘化油组肝功能损伤程度更高,差异有统计学意义(P<0.05)。结论：DEB-TACE治疗消化系统肝转移瘤的疗效更佳,肝功能损伤程度及不良反应发生率均低于cTACE,更加安全有效。     

含载药微球动脉化疗栓塞术方案治疗化疗无效的非小细胞肺癌的临床效果

目的 评价含载药微球动脉化疗栓塞术（TACE）方案治疗化疗无效的非小细胞肺癌（NSCLC）的临床效果。方法选取2019年4月至2021年4月江西省胸科医院收治的60例经化疗治疗无效的NSCLC患者作为研究对象,按照随机数字表法将其分为观察组（30例）与对照组（30例）。观察组采用含载药微球TACE方案治疗,对照组采用空白微球TACE方案治疗。比较两组患者临床疗效、癌胚抗原（CEA）、生活质量、无进展生存期（PFS）、总生存期（OS）及不良反应。结果 观察组患者的治疗有效率（RR）、疾病控制率（DCR）均高于对照组,差异有统计学意义（P<0.05）;治疗后,两组患者的CEA均低于本组治疗前,KPS评分均高于本组治疗前,且观察组患者的CEA低于对照组,KPS评分高于对照组,差异有统计学意义（P<0.05）;观察组患者的PFS及OS均长于对照组,差异有统计学意义（P<0.05）;两组患者的不良反应发生率比较,差异无统计学意义（P>0.05）。结论 含载药微球TACE方案治疗化疗无效的NSCLC对疾病进展的控制能力优于空白微球,有利于提高RR、DCR及生活质量,降低CE...     

不可降解动脉栓塞微球的研究进展

动脉栓塞是指将栓塞剂选择性地注入病变靶区供血动脉,有效阻断血流,以达到预定治疗目的的技术,治疗恶性肿瘤效果显著。微球作为栓塞剂的治疗效果更加安全有效,它具有独特的球形外观和良好的栓塞性能,是目前最常用的栓塞剂。按照基质的不同,动脉栓塞微球分为可降解和不可降解两类。文中对不可降解栓塞微球研究进展进行总结,着重介绍了各类栓塞微球的基础研究和临床应用状况,并探讨了栓塞微球的发展趋势。     

载药微球与碘油动脉化疗栓塞治疗巨块型肝癌效果对比研究

目的 探究CalliSpheres载药微球(CB)经动脉化疗栓塞(DEB-TACE)治疗治疗巨块型肝癌(HCC)的有效性和安全性.方法 选择我院收治的原发性巨块型肝癌患者60例为研究对象,随机分为DEB-TACE组和CTACE组;DEB-TACE组给予DEB-TACE介入治疗,CTACE组给予传统的碘化油动脉化疗栓塞(...     

磁性靶向载药微球研究进展

磁性靶向药物治疗具有疗效高、用药量少、不良反应小等特点,是近年来发展的一种新的治疗肿瘤的方法。该文主要介绍了靶向给药治疗的机制及磁性靶向载药微球的构成和研究进展,并对其发展前景进行了展望。     

载药微球制备的研究进展

微球作为新型给药载体,在提高药物稳定性、生物利用度尤其在药物缓控释,靶向方面优势明显,而这些优势在很大程度上取决于所选载体材料。就根据制备微球的常用载体的特点及具体制备方法进行了综述。     

经导管化疗栓塞治疗单发性肝细胞癌的疗效分析

目的 研究经肝动脉导管化疗栓塞(TACE)治疗肝硬化伴有单发的原发性肝癌(不适合外科手术切除和经皮射频消融治疗)的有效性.方法 回顾176例进行过TACE治疗的持续性肝硬化伴有单发性肝癌的患者.TACE是使用表阿霉素配制的剂量是50mg/m2,在30min内用注射器推注,然后使用碘油和明胶海绵进行栓塞.结果 患者总共接受了368次TACE的治疗平均(2.4±1.7)次.94名患者(58%)获得完全性肿瘤坏死,16名患者(10%)出现大部分坏死(90%～99%),18名患者(11%)获得部分性坏死(50%～89%),有34名患者(21%)肿瘤病灶很少坏死(＜50%).根据原发性肝癌癌灶大小等级,癌灶获得完全坏死的比例也不同,分别是69%,69%,52%,68%,50%和13%,相应的癌灶大小为,≤2.0,2.1～3.0,3.1～4.0,4.1～5.0,5.1～6.0,＞6.0cm.癌灶大小分别为:≤2.0,2.1～3.0,3.1～4.0,4.1～5.0,5.1～6.0,＞6.0cm的患者,Kaplan-Mayer 24个月生存率分别是88%,68%,59%,59%,45%,53%.结论 肝硬化患者中,伴有癌灶小于6.0cm的单发性原发性肝癌的患者,通过TACE治疗能对大部分患者的肿瘤产生局部控制的作用.因此,对于不能外科手术治疗或是经皮消融治疗的单发性原发性肝癌患者来说,TACE是一种有效的治疗选择.     

Regorafenib-loaded poly (lactide-co-glycolide) microspheres designed to improve transarterial chemoembolization therapy for hepatocellular carcinoma

Transarterial chemoembolization (TACE) has been widely introduced to treat hepatocellular carcinoma (HCC) especially for unresectable patients for decades. However, TACE evokes an angiogenic response due to the secretion of vascular endothelial growth factor (VEGF), resulting in the formation of new blood vessels and eventually tumor recurrence. Thus, we aimed to develop regorafenib (REGO)-loaded poly (lactide-co-glycolide) (PLGA) microspheres that enabled localized and sustained drug delivery to limit proangiogenic responses following TACE in HCC treatment. REGO-loaded PLGA microspheres were prepared using the emulsion-solvent evaporation/extraction method, in which DMF was selected as an organic phase co-solvent. Accordingly, we optimized the proportion of DMF, which the optimal ratio to DCM was 1:9 (v/v). After preparation, the microspheres provided high drug loading capacity of 28.6%, high loading efficiency of 91.5%, and the average particle size of 149 µm for TACE. IR spectra and XRD were applied to confirming sufficient REGO entrapment. The in vitro release profiles demonstrated sustained drug release of microspheres for more than 30 d To confirm the role of REGO-loaded microspheres in TACE, the cell cytotoxic activity on HepG2 cells and anti-angiogenic effects in HUVECs Tube-formation assay were studied in combination with miriplatin. Moreover, the microspheres indicated the potential of antagonizing miriplatin resistance of HepG2 cells in vitro. Pharmacokinetics preliminary studies exhibited that REGO could be sustainably released from microspheres for more than 30 d after TACE in vivo. In vivo anti-tumor efficacy was further determined in HepG2 xenograft tumor mouse model, demonstrating that REGO microspheres could improve the antitumor efficacy of miriplatin remarkably compared with miriplatin monotherapy. In conclusion, the obtained REGO microspheres demonstrated promising therapeutic effects against HCC when combined with TACE.     

TACE联合FOLFOX4方案治疗中晚期肝细胞癌的临床观察

目的:观察经导管肝动脉化疗栓塞术(TACE)联合FOLFOX4方案对中晚期肝细胞癌的疗效及不良反应。方法:回顾性分析2010年7月-2011年1月入住我院无法手术切除的中晚期肝细胞癌患者37例。每位患者行TACE至少2次,术后给予FOLFOX4辅助化疗:奥沙利铂85mg.m~(-2),静脉滴注2h,第1天;亚叶酸钙200mg.m~(-2),静脉滴注2h,第1、2天;5-氟尿嘧啶400mg.m~(-2),静脉推注后,以600mg.m~(-2)持续静脉滴注22h,第1、2天。每3周为1个周期。随访半年,评估疗效及不良反应。结果:治疗3月后,有效率为48.6%,肿瘤控制率为81.1%。不良反应为Ⅰ～Ⅲ度,经对症处理后可缓解。结论:TACE联合FOLFOX4方案治疗无法手术的中晚期肝细胞癌可获得较好有效率及肿瘤控制率,且不良反应可耐受。     

DC Bead embolic drug-eluting bead: clinical application in the locoregional treatment of tumours

Introduction: DC Bead is an embolic drug-eluting bead designed to be loaded with chemotherapeutic agents (such as doxorubicin and irinotecan), delivered intra-arterially into tumor blood vessels to block nutrient flow and then to deliver the drug locally in a sustained fashion. This product is finding increasing use in the treatment of patients with both primary and secondary liver cancers.

Areas covered: This review positions DC Bead in the field of targeted embolic drug delivery and with respect to other competitive technologies in the treatment of liver cancer. An overview of the studies that demonstrate the product's performance, safety and efficacy is presented. The clinical application of the doxorubicin loaded DC Bead is firstly reviewed, in the context of treatment of patients with various stages of hepatocellular carcinoma. Its combination with other therapies is also discussed, together with consideration of the treatment of other liver tumors. Secondly, the use of irinotecan loaded DC Bead, primarily for the treatment of colorectal cancer metastases to the liver, but also some additional rare metastases, is summarized.

Expert Opinion: An opinion is proffered as to how this technology and its application is evolving, illustrating a move towards synergistic combination therapies and into other cancer indications.     

Hyaluronic acid/doxorubicin nanoassembly-releasing microspheres for the transarterial chemoembolization of a liver tumor

Doxorubicin (DOX)-loaded, hyaluronic acid-ceramide (HACE) nanoassembly-releasing poly(lactic-co-glycolic acid) (PLGA) microspheres (MSs) were developed for transarterial chemoembolization (TACE) therapy of liver cancer. DOX/HACE MSs with a mean diameter of 27?μm and a spherical shape were prepared based on the modified emulsification method. Their in vitro biodegradability in artificial biological fluids was observed. A more sustained drug release pattern was observed from DOX/HACE MS than from DOX MS at pH 7.4. The cellular internalization efficiency of DOX of the DOX/HACE MS group was higher than that of the DOX MS group in liver cancer cells (HepG2 and McA-RH7777 cells), mainly due to CD44 receptor-mediated endocytosis of the released DOX/HACE nanoassembly. In both HepG2 and McA-RH7777 cells, the antiproliferation and apoptotic potentials of the DOX/HACE MS were significantly higher than those of the DOX MS (p?相似文献   

华蟾素预防和治疗原发性肝癌的临床研究进展

原发性肝癌是世界范围内常见的恶性肿瘤之一,目前对中晚期肝癌尚无特别有效的治疗措施。华蟾素是我国传统中药材中华大蟾蜍阴干皮经提取加工制成的灭菌水溶液,具有清热解毒、利水消胀、化瘀软坚、消肿止痛等功效,是我国应用较为广泛的一类抗肿瘤中药制剂。临床研究表明,华蟾素对乙型肝炎有一定的抑制作用,可有效地抑制原发性肝癌的发生;同时,利用华蟾素单纯静脉滴注、静脉滴注联合其他药物、静脉滴注联合肝动脉化疗栓塞、肝动脉化疗栓塞及肝内注射等治疗方法,对中晚期肝癌病人也具有较好的疗效。本文对近年来华蟾素预防和治疗原发性肝癌的临床疗效进行综述。     

Research progress and clinical prospect of immunocytotherapy for the treatment of hepatocellular carcinoma

As a common malignant tumor, hepatocellular carcinoma (HCC) has high fatality rate due to its strong metastasis and high degree of malignancy. Current treatment strategies adopted in clinical practice were still conventional surgery, assisted with interventional therapy, radiotherapy and chemotherapy. However these treatments have limited effects with high recurrence rate. Current research progress of immunocytotherapy has shown that tumor cells can be directly identified and killed by stimulating the immune function and enhancing the anti-tumor immunity in tumor microenvironment. Targeted immunotherapeutics have therefore become the hope of conquering cancer in the future. It can kill tumor cells without damaging the body's immune system and function, restore and strengthen the body's natural anti-tumor immune system. It can reduce the toxic side effects of radiotherapy and chemotherapy, reduce the recurrence rate and prolong the survival period of patients with HCC. Currently, the immune cells widely studied are mainly as follows: Dendritic cells (DC), Cytokine-induced killer (CIK), DC-CIK, Chimeric antigen receptor T cells (CAR-T), Tumor infiltrating lymphocyte (TIL) and Natural killer cell (NK). Immunocytotherapy is a long-term treatment method, some studies have combined traditional therapy with immunocytotherapy and achieved significant effects, providing experimental basis for the application of immunocytotherapy. However, there are still some difficulties in the clinical application of immune cells. In this article, we discuss the application of immunocytotherapy in the clinical treatment of HCC, their effectiveness either alone or in combination with conventional therapies, and how future immunocytotherapeutics can be further improved from investigations in tumour immunology.     

灵丹草油提取工艺及其主要成分研究

目的采用L9（34）正交试验法,研究灵丹草油最优提取工艺,分析灵丹草油的成分组成。方法以灵丹草油提取量为评价指标,以加水量、浸泡时间、提取时间为因素进行正交试验;采用GC-MS对灵丹草油主要成分进行分离分析。结果最佳提取工艺条件为加水10倍量,浸泡2h,加热提取8h;从灵丹草油中分离鉴定了20种主要化合物。结论优选的提取工艺稳定可行;α-可巴烯、β-芹子烯及1,2,3,4,4a,5,6,7-八氢-4a,8-二甲基-α-亚甲基-2-萘乙酸是灵丹草挥发油的主要成分,它们相对含量之和占到了灵丹草油的34.63%。