联合丝裂霉素、碘油及肝动脉栓塞对大鼠肝癌的介入治疗

目的:建立Walker256大鼠肝癌模型,探讨碘油、栓塞及化疗在肝动脉化疗栓塞术中的作用.方法:将皮下种植生长出的Walker256细胞瘤结节切成约1.5mm3大小的瘤块,植入35只♂SD大鼠肝包膜下,植入后9d用磁共振(magnetic resonance imaging,MRI)测量肿瘤体积V1,经胃十二指肠动脉逆行插管至肝动脉注入不同药物,分为实验组:A组(n=7),0.1mg丝裂霉素(mitomycin,MMC)+0.1mL碘油(lipiodol,LP)+肝动脉结扎(hepatic artery ligation,HAL);B组(n=7),0.1mg MMC+0.1mL LP;C组(n=7),0.1mg MMC+HAL;D组(n=7),0.1mL LP+HAL;对照组:E组(n=7),0.1mL0.9%生理盐水.介入术后9d采用MRI测量肿瘤体积V2及肿瘤增长率(V2/V1).结果:介入治疗术前,A、B、C、D、E各组肿瘤平均体积V1分别为:0.017cm3±0.008cm3、0.019cm3±0.011cm3、0.022cm3±0.010cm3、0.019cm3±0.008cm3、0.021cm3±0.006cm3,术后肿瘤平均体积V2分别为:0.038cm3±0.017cm3、0.152cm3±0.069cm3、0.302cm3±0.134cm3、0.382cm3±0.049cm3、0.715cm3±0.307cm3.肿瘤平均增长率V2/V1分别为:2.50±1.08、8.73±2.38、14.66±4.96、21.26±5.19、33.10±8.17.治疗后A、B、C、D各实验组肿瘤平均增长率明显低于对照组E组(P<0.05);A、B、C、D各组间两两比较肿瘤平均增长率也具有显著性差异(P<0.05).结论:丝裂霉素与碘油及肝动脉结扎(LP+MMC+HAL)三者联合应用治疗肝癌取得了满意的疗效,较其中任2种联合应用有明显优势,有较好的临床应用前景.     

碘油化疗药物栓塞治疗肝细胞癌24例报告

目的分析碘油化疗药物栓塞治疗失去手术时机肝细胞癌的疗效。方法采用seldinger插管方法，将导管插入肝动脉或更接近肿瘤的供血动脉，先灌注化疗药物，再用碘油与化疗药物混悬液在X线监控下栓塞肿瘤血管，直至肿瘤区碘油沉积充分后再用明胶海绵栓塞。结果6个月生存率91．6％，12个月生存率41．6％，24个月生存率4．2％，平均生存13．6月。结论碘油化疗药物栓塞治疗中晚期肝细胞癌患者能适当延长病人的生存期。     

经动脉热化疗治疗肝癌的临床应用

目的　研究经肝动脉灌注热化疗药治疗肝癌的有效性及安全性。方法　对３５ 例肝癌患者行肝动脉插管热化疗,碘油、５Ｆｕ 及卡铂加热至６０ ～６５°Ｃ后经导管灌入肝动脉,其余药物不加热。９例重复治疗,与同期１４ 例作２ 次或以上普通介入治疗的肝癌患者比较。４ 例热化疗后２ ～３ 个月手术切除,与同期普通介入治疗后手术切除的４ 例作比较。结果　热化疗组的肿瘤生长率为－ １０ ．０％±３３．３ ％ ,对照组的肿瘤生长率为３６ ．４％ ±５９．０％ ,差异有显著性（Ｐ＜ ０．０５） 。手术切除标本的坏死率（大体）分别为９３．５ ％ ±５ ．９７ ％ 及７３．５ ％ ±２８ ．３８ ％ ,但差异无显著性,显微镜下观表现相似。肝动脉损伤各一例。热化疗组中１９ 例行“夹心面包”疗法,与普通“夹心面包”疗法的２２ 例比较,其轻、中度毒副反应分别为７３．７％ 和６３．６％ ,重度反应为２６ ．３ ％ 和３７ ．４ ％ ,但差异无显著性。结论　经肝动脉灌注６０～６５°Ｃ的碘油、化疗药合并明胶海绵栓塞肝动脉治疗肝癌是简单、安全的方法,能显著提高单纯化疗、栓塞的疗效。     

碘油乳剂肝动脉栓塞治疗肝癌临床分析

肝脏肿瘤缺乏特异症状,目前临床诊断的病例手术切除率低于50％。1976年Gold-stein应用肝动脉栓塞治疗肝癌获得成功以来,肝动脉栓塞术在临床上已越来越受到重视。本组手术中采用碘油乳剂经肝动脉栓塞治疗肝癌27例,现结合文献报告如下。     

FAMD方案与碘油混合栓塞肝动脉治疗晚期肝癌的实验及临床研究

目的：研究FAMD方案与碘油混合栓塞治疗肝癌的疗效。材料和方法：30例肝癌病人在CT引导下行肿块穿刺活检，并将部分穿刺组织行药物敏感试验；36例病人行FAMD方案(ADM60mg，MMC20mg，DDP40～60mg，5-Fu1000mg)与40％碘化油／超液化油10～20ml混台栓塞肝动脉。观测一次治疗后3～6周复诊时AFP下降，肿块体积缩小情况。同期41例病人未行混合栓塞，为对照组。结果：药敏试验表明ADM、MMC、DDP、5-FU均为高敏药物，它们与肿瘤细胞孵育时，浓度，时间与杀瘤率正相关。临床结果表明混合栓塞治疗优于灌注后栓塞治疗。结论：混台栓塞治疗是有依据的，值得推广应用。     

薏苡仁油联合奥沙利铂对结肠癌细胞增殖、凋亡的影响

目的 分析薏苡仁油联合奥沙利铂对结肠癌HT-29细胞株增殖、凋亡的影响及其作用机制。方法 将人结肠癌HT-29细胞株作为研究对象,采用四甲基偶氮唑蓝(MTT)法测定不同浓度注射用薏苡仁油和奥沙利铂联合作用对人结肠癌HT-29细胞株增殖的影响,采用流式细胞术检测细胞凋亡情况,采用逆转录聚合酶链反应(RT-PCR)检测Suvivin表达水平。结果 薏苡仁油组、奥沙利铂组、奥沙利铂+薏苡仁油组均会对人结肠癌HT-29细胞增殖产生一定抑制作用,且薏苡仁油浓度越高,作用时间越长,细胞增殖抑制率越高,差异有统计学意义(P<0.05);与薏苡仁油组、奥沙利铂组相比,奥沙利铂+薏苡仁油组细胞增殖抑制率更高,差异有统计学意义(P<0.05);薏苡仁油组、奥沙利铂组、奥沙利铂+薏苡仁油组细胞凋亡率均明显高于空白对照组(P<0.05);薏苡仁油浓度越高,细胞凋亡率也越高,差异有统计学意义(P<0.05);奥沙利铂+薏苡仁油组细胞凋亡率明显高于单独奥沙利铂组、薏苡仁油组,差异有统计学意义(P<0.05);空白对照组中Survivin mRNA为阴性表达,将不同浓度薏苡仁油加入行4...     

莪术油肝动脉灌注治疗大鼠移植性肝癌

目的观察莪术油经动脉灌注对大鼠移植性肝癌的治疗作用．方法复制４０只大鼠移植性肝癌模型，随机分为治疗组与对照组，每组各２０只．经胃十二指肠动脉至肝固有动脉分别灌注莪术油（１０ｍｇ／ｋｇ）及生理盐水（０２ｍＬ～０３ｍＬ）．结果与对照组比较，莪术油治疗组大鼠的肿瘤生长（ＧＲ）受到显著抑制（１０８％±４５％ｖｓ２０６％±１２７％，Ｐ＜００５），肿瘤坏死程度加重（Ｐ＜００１），生存时间明显延长（１４８ｄ±３４ｄｖｓ１１７ｄ±１９ｄ，Ｐ＜００５）．结论莪术油经肝动脉灌注对大鼠移植性肝癌具有治疗作用．     

肝动脉灌注化疗和栓塞治疗老年肝脏恶性肿瘤

目的 观察用导管法肝动脉灌注化疗和栓塞治疗36例老年肝癌临床疗效。方法 将化疗药物经导管灌注肝动脉，化疗药与碘油混悬乳化流入肝肿瘤血管，再用明胶海绵颗粒栓塞血管。结果 经长期随访，存活≥5年l例，≥3年2例，≥2年2例，≥1年10例，9月以上2l例。结论 化疗栓塞后，病人症状缓解，甲胎蛋白值下降，肿瘤缩小，延长患者寿命。     

生物微球联合碘油经肝动脉栓塞化疗治疗原发性肝癌临床观察

目的观察生物微球联合碘油经肝动脉栓塞化疗(TACE)治疗不能手术切除的原发性肝癌患者的临床疗效。方法选择本院2010年1月至2012年12月40例行选择性肝动脉栓塞化疗时使用生物微球联合碘油栓塞化疗的原发性肝癌患者和42例行选择性肝动脉栓塞时使用碘油栓塞化疗的患者,每例行栓塞术4次以上,于首次术后1、3、6、12和24 m随访生存患者肝功能、甲胎蛋白、腹部增强CT等变化,比较治疗后病灶缩小程度,观察肿瘤部分缓解率及患者生存率。结果在首次术后3个月时,微球联合组肿瘤缓解率为(57.44%),明显高于TACE组[(45.23%),P0.05],6个月时微球联合组AFP为(296.7±96.3)ng/ml,明显低于TACE组[(346.9±118.3)ng/ml,P0.05],12个月时微球联合组肿瘤直径为(3.36±1.37)cm,明显低于TACE组[(4.98±1.87)cm,P0.05],24个月时微球联合组生存率为(15.0%),明显高于TACE组[(2.3%),P0.05]。结论生物微球联合碘油栓塞化疗治疗患者病灶缩小程度、AFP下降水平、肿瘤部分缓解率及患者生存率明显高于单纯碘油栓塞化疗组,生物微球联合碘油栓塞化疗治疗中晚期原发性肝癌疗效确切,临床疗效优于单纯栓塞化疗,且安全可行。     

肝动脉插管化疗栓塞联合射频消融对大肝癌疗效评价

目的 探讨经导管肝动脉化疗栓塞(TACE)联合射频消融(RFA)治疗大肝癌的临床应用价值.方法 收集我院2006年4月～2008年7月肝细胞癌患者66例,并将其分为经导管肝动脉化疗栓塞+射频消融组(19例)、经导管肝动脉化疗栓塞组(24例)和射频消融组(23例),并将其疗效进行比较.结果 经导管肝动脉化疗栓塞+射频消融组的肿瘤坏死率达73.68％,明显高于单纯经导管肝动脉化疗栓塞组及单纯射频消融组(分别为50.00％和52.17％,P＜0.01或P＜0.05).局部复发率分别为26.32％、37.50％和30.43％,3组比较差异无统计学意义(P＞0.05).经导管肝动脉化疗栓塞+射频消融组的平均生存期为28.3个月,高于经导管肝动脉化疗栓塞组与单纯射频消融组(分别为13.6个月、21.7个月,P＜0.01或P＜0.05).结论 经导管肝动脉化疗栓塞联合射频消融治疗大肝癌与单纯经导管肝动脉化疗栓塞和单纯射频消融治疗效果相比,可提高肿瘤坏死率,延长患者生存期.     

Changes of tumor microcirculation after transcatheter arterial chemoembolization： First pass perfusion MR imaging and Chinese ink casting in a rabbit model

AIM: To observe the change of tumor microcirculation after transcatheter arterial chemoembolization (TACE) with bletilla microspheres by using first pass perfusion MR imaging (FP) and Chinese ink casting.METHODS: VX2 carcinoma cells were surgically implanted into the left and right lobes of liver of 30 New Zealand white rabbits, which were divided into 3 groups at random. Emulsion of lipiodol mixed with mitomydn C, and 5-FU bletilla microspheres were injected into the hepatic artery respectively, and saline was used as control agent. MR imaging was performed with turbo-flash sequence 14 d after tumor implantation and 7 d after interventional therapy. The steepest slopes (SS) of the signal intensity versus time curves were created for quantitative analysis, 7.5% Chinese ink gelatin solution was injected through ascending artery (17 cases) or portal vein(2 cases) for lesion microvessel area (MVA) measurement after the last MRI examination.The correlation between perfusion imaging and MVA was studied blindly.RESULTS: The SS values at the rim of tumor in lipiodol group (mean, 49% per second) and bletilla group (mean,35% per second) were significantly decreased (P&lt;0.05) as compared with control group (mean, 124% per second), no difference was found between lipiodol and bletilla groups(P&gt;0.05). In lipiodol group, the MVAs (24 974&#177;11 836μm^2) in the center of the tumor were significantly smaller than those of the control group (35 510&#177;15 675 μm^2) (P&lt;0.05),while the MVAs (80 031&#177;22 745 μm^2) around the tumor were significantly increased because small and dense plexuses appeared around the tumor which correlated to intense reaction of granulation tissue. None of the vessels was seen in the tumor in bletilla group, the peripheral MVAs of the tumor were significantly smaller than those of the control group (P&lt;0.05) and lipiodol group (P&lt;0.05). There was a good correlation between SS and MVAs in control group (rsl, 0.985, P&lt;0.0001) and bletilla group (rsl, 0.743,P&lt;0.05), the correlation was not significant in lipiodol group(rsl, 0.527, P&gt;0.05).CONCLUSION: TACE with bletilla microspheres may enhance its anti-tumor effect by inhibiting the angiogenesis,and FP-MRI provides useful information to assess the TACE effect by depicting tumor vascularization and perfusion,     

抗病毒治疗对乙型肝炎相关原发性肝癌患者生活质量及预后的影响

目的 探讨抗病毒治疗对乙型肝炎相关原发性肝癌患者生活质量的影响.方法 选择95例诊断为乙型肝炎相关性原发性肝癌且无手术治疗指征的患者,分为抗病毒联合介入治疗组22例、介入治疗组26例、抗病毒治疗组23例、常规治疗组24例.随访监测治疗后4、12、24及48周肝功能、腹部彩色超声或肝脏CT,每4周对患者生活质量包括食欲、体质量(排除腹水影响因素)及乏力情况进行现场或电话随访,所有患者随访4周至48周.统计学处理采用t检验和x2检验.结果 抗病毒联合介入治疗组、介入治疗组、抗病毒治疗组与常规治疗组患者24周生存率分别为86.4％(19例)、73.1％(19例)、73.9％(17例)、54.2％(13例),48周生存率分别为68.2％(15例)、46.2％(8例)、47.8％(11例)、16.7％(4例).抗病毒联合介入治疗组、介入治疗组及抗病毒治疗组患者1年生存率明显高于常规治疗组(P＜0.05).抗病毒联合介入治疗组、介入治疗组及抗病毒治疗组患者12周内生活质量较常规治疗组明显改善,其中抗病毒联合介入治疗组改善最明显,其次为介入治疗组与抗病毒治疗组,常规治疗组在生活质量方面无明显改善.治疗24周后抗病毒联合介入治疗组及介入治疗组的肿瘤大小未明显增大,而常规治疗组患者的肿瘤较抗病毒治疗组增大明显.结论 在介入治疗及常规治疗的基础上联合抗病毒治疗可提高乙型肝炎相关原发性肝癌患者1年生存率、改善生活质量、延缓肿瘤生长.     

Vascular endothelial growth factor antisense oligodeoxynucleotides with lipiodol in arterial embolization of liver cancer in rats

AIM:Transcatheter arterial embolization (TAE) of the hepatic artery has been accepted as an effective treatment for unresectable hepatocellular carcinoma (HCC). However,embolized vessel recanalization and collateral circulation formation are the main factors of HCC growth and recurrence and metastasis alter TAE. Vascular endothelial growth factor (VEGF) plays an important role in tumor angiogenesis.This study was to explore the inhibitory effect of VEGF antisense oligodeoxynucleotides (ODNs) on VEGF expression in cultured Walker-256 cells and to observe the anti-tumor effect of intra-arterial infusion of antisense ODNs mixed with lipiodol on rat liver cancer.METHODS: VEGF antisense ODNs and sense ODNs were added to the media of non-serum cultured Walker-256 cells.Forty-eight hours later, VEGF concentrations of supernatants were detected by EUSA. Endothelial cell line ECV-304 cells were cultured in the supernatants. Seventy-two hours later,growth of ECV-304 cells was analyzed by NTT method. Thirty Walker-256 cell implanted rat liver tumor models were divided into 3 groups.0.2 mL lipiodol (LP group, n=10), 3OD antisense ODNs mixed with 0.2 mL lipiodol (LP+ODNs group, n=10) and 0.2 mL normal saline (control group, n=10) were infused into the hepatic artery. Volumes of tumors were measured by MRI before and 7 d alter the treatment.VEGF mRNA in cancerous and peri-cancerous tissues was detected by RT-PCR. Microvessel density (MVD) and VEGF expression were observed by immunohistochemistry.RESULTS: Antisense ODNs inhibited Walker-256 cells‘ VEGF expression, The tumor growth rate was significantly lower in LP+ODNs group than that in LP and control groups (140.1&#177;33.8%, 177.9&#177;64.9% and 403.9&#177;69.4% respectively, F=60.019,P&lt;0.01).VEGF mRNAs in cancerous and peri-cancerous tissues were expressed highest in LP group and lowest in LP+ODNs group. The VEGF positive rates showed no significant difference among LP, control and LP+ODNs groups (90%,70% and 50%, H=3.731, P&gt;0.05).The MVD in LP+ODNs group (53.1&#177;18.4) was significantly less than that in control group (73.2&#177;20.4) and LP group(80.3&#177;18.5) (F=5.44, P&lt;0.05).CONCLUSION: VEGF antisense ODNs can inhibit VEGF expression of Walker-256 cells.It may be an antiangiogenesis therapy agent for malignant tumors. VEGF antisense ODNs mixed with lipiodol embolizing liver cancer is better in inhibiting liver cancer growth, VEGF expression and microvessel density than lipiodol alone.     

A novel transcatheter arterial infusion chemotherapy using iodized oil and degradable starch microspheres for hepatocellular carcinoma: a prospective randomized trial

Background

We designed a novel transcatheter arterial infusion chemotherapy (TAI) using iodized oil (lipiodol) and degradable starch microspheres (DSM) for hepatocellular carcinoma (HCC) patients. In this study, we investigated the efficacy of TAI using lipiodol and DSM in a prospective randomized trial.

Methods

We randomly divided 45 patients with HCC into 3 groups: TAI using lipiodol (lipiodol group, n?=?15), TAI using DSM (DSM group, n?=?15), and TAI using lipiodol and DSM (lipiodol?+?DSM group, n?=?15). In the lipiodol group, a mixture of cisplatin and lipiodol was administered. In the DSM group, a mixture of cisplatin and DSM was administered. In the lipiodol?+?DSM group, a mixture of cisplatin and lipiodol was administered, followed by DSM.

Results

The response rates were 40% in the lipiodol group, 53.4% in the DSM group, and 80% in the lipiodol?+?DSM group, respectively. The response rate tended to improve in the lipiodol?+?DSM group (lipiodol group vs. lipiodol?+?DSM group, P?=?0.07). The median progression-free survival time was 177?days in the lipiodol group, 287?days in the DSM group, and 377?days in the lipiodol?+?DSM group. The progression-free survival in the lipiodol?+?DSM group was significantly better than those in the DSM group (P?=?0.020) and the lipiodol group (P?=?0.035). There were no serious adverse effects among the 3 groups.

Conclusions

TAI using lipiodol and DSM was superior to TAI using lipiodol only and TAI using DSM only because of improvements in therapeutic effects and progression-free survival.     

体部伽玛刀与三维适形放射治疗原发性肝癌临床疗效比较

目的比较肝动脉介入栓塞化疗(TACE)联合伽玛刀治疗与TACE联合三维适形放射治疗原发性肝癌(HCC)的疗效。方法将50例不能手术的Ⅱa或Ⅱb期HCC患者根据患者意愿和适应证分为TACE+伽玛刀治疗组(A组)25例与TACE+三维适形放射治疗组(B组)25例,两组一般情况无统计学差异。A组先行TACE(40%碘化油+CPDD+5-FU+EADM)治疗2～3次后,再进行体部伽玛刀放射治疗。B组先行2～3次TACE治疗后,再行加速器适形放射治疗。结果治疗后3个月评价疗效,A组RR率(CR+PR)为84%(21/25),1、2、3年生存率分别为76%,45.9%,20.44%。B组的RR率为56%(14/25),与A组比较差异有统计学意义(P<0.05),B组1、2、3年生存率分别为79.6%,30.2%,12.6%,与A组比较差异无统计学意义(P>0.05)。结论与TACE联合适形放射治疗相比,TACE联合伽玛刀治疗HCC具有较高的近期有效率,而两种治疗的1、2、3年生存期差异无统计学意义。     

Comparative study of different interventional therapies for primary liver cancer

AIM: To compare the therapeutic effect of three types of inter-ventional management for primary liver cancer.METHODS: A total of 468 patients with primary liver cancer were randomly allocated to the following three groups: 138 cases treated with chemotherapy alone using mitomycin C, adriamycin and 5-FU (group A); 158 cases treated with chemoembolization using lipiodol (group B); and 172 cases with chemoembolization using lipiodol and gelfoam (group C). All patients were angiographically and sonographically followed-up.RESULTS: In group C, 67.5% patients had AFP value decreased by > 50%, which was much higher than the 43.3% in group B and 32.2% in group A. Tumor size reduction by ≥ 50% occurred in 20.3% of patients in group A, 41.2% of patients in group B and 44.8% of patients in group C. The intergroup differences between group A and group B or C were significant (P < 0.01). The 1-year and 3-year survival rates were 20.5% ± 3.6% and 1.9% ± 2.4% for group A, 51.3% ± 4.4% and 10.1% ± 4.9% for group B, and 63.0% ± 2.4% and 13.9% ± 5.0% for group C, respectively. The differences between all three groups were significant (P < 0.05). The mean survival time for patients in groups A, B and C were 9.6 mo, 16.1 mo and 17.9 mo, respectively.CONCLUSION: Chemoembolization with lipiodol and gelfoam was the most effective therapy for primary liver cancer in this study. The position of the embolization should be far and middle sections of the hepatic artery, and the proximal section should be reserved as the route of the next intra-arterial chemoembolization.     

CT导引双介入疗法治疗肝癌

目的评价ＣＴ导引双介入疗法治疗肝癌的效果。方法１５０例肝癌患者中６４例行单纯经导管肝动脉内含碘化油明胶海绵化疗栓塞术（ＬｐＧｓＴＡＥ），８６例行ＣＴ导引双介入治疗（ＣＴＤＩＴ），即指经皮肝肿瘤内无水乙醇注射（ＰＥＩ）和ＬｐＧｓＴＡＥ方法的联合应用。观察两组的疗效和生存率。结果ＣＴＤＩＴ组完全缓解率为６２８％，ＬｐＧｓＴＡＥ组为３７５％，ＣＴＤＩＴ组疗效优于ＬｐＧｓＴＡＥ组；两组病死率比较，ＣＴＤＩＴ组低于ＬｐＧｓＴＡＥ组，差异有极显著意义。结论采用ＬｐＧｓＴＡＥ治疗肝癌有一定局限性，而采用ＣＴＤＩＴ治疗可弥补其不足。尤其对于不能手术的肝癌，ＣＴＤＩＴ是一种安全有效的方法     

耐多药空洞肺结核的介入治疗

目的　探讨耐多药空洞肺结核介入治疗的意义。方法 采用 36例临床培养的耐药菌株作耐药结核菌抑制试验、临床对照观察的方法。 1 80例耐多药空洞肺结核住院患者随机分成两组,均用 3DLOZA/1 8DLOZ化疗方案治疗,治疗组 86例配合抗结核药物凝胶介入治疗并完成疗程。结果 提高抗结核药物浓度,可有效控制耐药结核菌生长,而所需浓度远远低于药物凝胶的含药浓度。临床观察治疗组比对照组痰菌阴转率高 (88.4%),痰菌阴转速度也快,空洞闭合率高 (43.0%),空洞闭合速度快,疗效较好。单发空洞、干酪空洞的疗效比多发空洞、纤维空洞的疗效较好。未发现与介入药物凝胶有关的不良反应。结论 经纤支镜引导灌注抗结核药物凝胶,是治疗耐多药空洞肺结核的有效方法,其有净化空洞,促使痰菌转阴,空洞闭合的作用。并且有安全无创,无明显不良反应,并发症少的优点,值得临床推广使用。     

吉西他滨对Lewis肺癌放射增敏的实验研究

目的　吉西他滨是一种核苷类似物,能够掺入到肿瘤细胞的DNA分子中,有效抑制DNA合 成。本实验观察联合应用吉西他滨和放疗治疗荷Lewis肺癌实体瘤C57BL小鼠的疗效,以明确吉西他滨 对Lewis瘤的放射增敏作用。方法　建立小鼠Lewis肺癌实体瘤模型后,分对照组、单纯放疗组、吉西他滨 组及吉西他滨联合放疗组。对照组给予腹腔注射生理盐水0.1ml,单纯放疗组荷瘤鼠右下肢肿瘤局部以 34Gy射线照射,吉西他滨组分两个亚组,分别以25mg/kg、50mg/kg吉西他滨腹腔注射,联合放疗组则以 25mg/kg吉西他滨腹腔注射加荷瘤鼠右下肢肿瘤局部34Gy射线照射。然后每两天测量肿瘤的长、短径, 比较各组瘤体积、肿瘤生长延缓天数、荷瘤鼠存活数和肺转移率等。结果　与对照组比较,25mg/kg和 50mg/kg的单剂量吉西他滨都对Lewis实体瘤生长有抑制作用(P<0.05);联合放疗组局部肿瘤生长受 到明显抑制,抑瘤率为86.6%,明显高于单纯放疗组(64.7%,P<0.05)和吉西他滨组(47.3%,P< 0.05);联合放疗组肿瘤生长延缓天数(瘤体积0.3～1.0cm3)超过9天,高于单纯放疗组(5天,P<0.05) 和吉西他滨组(3天,P<0.05);联合放疗组60天内存活的鼠最多(4个),单纯放疗组为2个,其他两组鼠 全部死亡。联合放疗组平均肺转移为0.5个/叶肺,单纯放疗组为1.5个/叶肺,吉西他滨组