肝动脉插管化疗栓塞与联合电化学治疗肝癌的疗效比较

目的:对肝动脉插管化疗栓塞(TACE)联合电化学治疗(ECT)与单纯采用TACE治疗中晚期肝癌的疗效进行比较.方法:将40例失去手术机会的中晚期肝癌患者随机分成A、B两组.A组在TACE间期配合ECT治疗,B组单纯接受TACE治疗.结果:A组有4例完全缓解(CR),12例部分缓解(PR),CR PR为80%.有7例获得二期手术切除,1年存活率65%.甲胎蛋白(AFP)从治疗前的752.18±423.39μg/L降至206.28±189.24μg/L.B组有1例CR,9例PR,CR PR 50%.有3例获得切除,1年存活率 40%.AFP从治疗前的782.61±491.23μg/L降至411.26±325.17μg/L.两组有效率(PR CR)及切除率有显著差异(P<0.05).结论:TACE联合ECT治疗中晚期肝癌的疗效优于单纯的TACE治疗.     

肝动脉插管化疗栓塞配合电化学治疗中晚期肝癌

目的　研究肝动脉插管化疗栓塞(TACE)结合电化学治疗(ECT)在中晚期肝癌治疗中的作用。　方法　对17例失去手术机会的中晚期肝癌在TACE间期结合ECT。　结果　3例完全缓解(CR),11例部分缓解(PR),CR PR为824%。有6例获得切除,一年生存率647%。甲胎蛋白(AFP)从治疗前的(73512±41439)μg/L降至(21039±19901)μg/L。　结论　TACE配合ECT治疗不能手术的中晚期肝癌疗效确切,值得推广     

肝动脉栓塞化疗加电化学治疗肝癌近期疗效观察

目的：比较无手术指征肝癌患者单纯肝动脉栓塞化疗与在肝动脉栓塞化疗基础上行电化学治疗的近期疗效。方法：选择无手术指征的肝癌患者59例,随机分为单纯肝动脉栓塞化疗组（化疗组）和肝动脉栓塞化疗加电化学治疗组（化疗＋电疗组）,比较两种治疗方法的近期疗效。结果：在肝动脉栓塞化疗基础上行电化学治疗在肿瘤缩小、肝区疼痛消失方面优于单纯肝动脉栓塞化疗。结论：无手术指征肝癌患者在肝动脉栓塞化疗的基础上行电化学治疗近期疗效显著。     

肝动脉插管化疗栓塞治疗中晚期肝癌及其并发症的防治

我们运用导管法治疗６５例中晚期肝癌，巨块型占６１．３％，结节型占２６．１％，弥漫型占２１．６％，患者肿瘤直径约３ｃｍ～１８ｃｍ不等。随访６－３３个月，多数患者治疗后肿瘤缩小，单纯灌注化疗组１２个月生存率为６．６％，化疗＋碘油＋明胶海绵生存率最高为３７．５％，最长的１例，生存３０个月。影响疗效的因素有：（１）肿瘤分期，（２）门静脉癌栓，（３）肝动脉治疗方法。并探讨治疗后并发症的产生原因和预防措施。     

肝动脉插管化疗栓塞治疗中晚期肝癌及其并发症的防治

我们运用导管法治疗65例中晚期肝癌，巨块型占61.3%，结节型占26.1%，弥漫型占21.6%，患者肿瘤直径约3cm-18cm不等。随访6－33个月，多数患者治疗后肿瘤缩小，单纯灌注化疗组12个月生存率为6.6%，化疗＋碘油＋明胶海绵生存率最37.5%，最长的1例，生存30个月。影响疗效的因素有：（1）肿瘤分期，（2）门静脉癌栓，（3）肝动脉治疗方法。并探讨治疗后并发症的产生原因和预防措施。     

卡培他滨联合肝动脉插管化疗栓塞治疗中晚期肝癌的研究

 目的 探讨卡培他滨（商品名：希罗达）联合肝动脉插管化疗栓塞（TACE）在中晚期肝癌中的临床应用。方法 肝癌患者随机分为两组，治疗组12例，对照组15例。治疗组采用TACE3周后，口服希罗达每日2 500 mg／m2，分2次服，服用14 d，停药7 d为1个疗程，后行TACE；对照组采用单纯TACE治疗，两组中TACE治疗每6周1次。结果 治疗组和对照组中，总有效率分别为66.7 ％，20 ％；肿瘤缩小率各为75 ％，30 ％；甲胎蛋白（AFP）下降率各为70 ％，30.8 ％；中位生存期各为12.2个月，7.6个月（P＜0.05）。服用希罗达主要毒副反应为手足综合征、腹泻、骨髓抑制，肝脏毒性，多为1～2级，可耐受。结论 希罗达联合TACE治疗中晚期肝癌安全、有效，优于单纯TACE。     

肝动脉泵内化疗治疗晚期肝癌的临床研究

目的：观察肝动脉泵内化疗对晚期肝癌的疗效。方法：泵内予以ＦＤ和ＦＭ方案交替小剂量化疗（每周一次,６个月为一疗程）治疗１２例晚期肝癌患者。结果：ＣＲ４例,ＰＲ４例,ＮＣ２例,ＰＤ２例。有效率为６６．７％（８／１２）。３年及５年生存率分别为３３．３％和１６．７％。结论：泵内长期小剂量化疗可以提高晚期肝癌的生存率。     

肝动脉栓塞化疗加电化学治疗肝癌近期疗效观察

目的 :比较无手术指征肝癌患者单纯肝动脉栓塞化疗与在肝动脉栓塞化疗基础上行电化学治疗的近期疗效。方法 :选择无手术指征的肝癌患者 59例 ,随机分为单纯肝动脉栓塞化疗组 (化疗组 )和肝动脉栓塞化疗加电化学治疗组 (化疗 电疗组 ) ,比较两种治疗方法的近期疗效。结果 :在肝动脉栓塞化疗基础上行电化学治疗在肿瘤缩小、肝区疼痛消失方面优于单纯肝动脉栓塞化疗。结论 :无手术指征肝癌患者在肝动脉栓塞化疗的基础上行电化学治疗近期疗效显著。     

肝动脉插管化疗治疗原发性肝癌

我院于1964年4月至1986年12月间,以肝动脉插管化疗为主治疗原发性肝癌87例,随访至1988年12月,全部病例均已死去。治疗后半年和1年生存率分别为25.28％和9.19％。肝大程度、血清硷性磷酸酶、组织学分类和有无肝硬变是影响半年生存率的最重要因素。本文还结合文献进行了简要的讨论。     

乌体林斯合并肝动脉插管化疗治疗肝癌的疗效观察

乌体林斯（主要成份为灭活划分枝杆菌）通过提高中晚期肝癌Ｔ细胞亚群（ＣＥ３、ＣＤ４、ＣＤ４／ＣＤ８）及ＮＫ细胞活性,从而增强了机体对化疗药物的耐受性,运用乌体林斯的治疗组接受肝动脉插管化疗栓塞（ＴＡＣＥ）次数显著增加,近期疗效及１年存活率显著优于单纯行ＴＡＣＥ的对照组。     

Hepatic arterial infusion of chemotherapy for advanced hepatocellular carcinoma

Treatment of advanced hepatocellular carcinoma (HCC) remains a significant problem for clinicians. Sorafenib, the only approved agent, improves survival rate, but is associated with a low tumor response rate. Alternative approaches for the treatment of advanced HCC are urgently needed. Hepatic arterial infusion of chemotherapy (HAIC) is a promising modality for the treatment of advanced HCC. Since its introduction, there have been improvements in implantable pumps, in catheter implantation and in the convenience and safety of HAIC in general. Numerous clinical studies have shown that HAIC provides moderate therapeutic efficacy with substantially favorable toxicity profiles in selected patient groups with advanced HCC. However, the lack of large randomized studies means that HAIC is not yet a well‐established treatment for advanced HCC. We believe there is an urgent need for the further investigation of HAIC for the treatment of advanced HCC.     

The efficacy of hepatic arterial infusion chemotherapy as an alternative to sorafenib in advanced hepatocellular carcinoma

Aims: Sorafenib is the only systemic treatment shown to be effective against advanced hepatocellular carcinoma (HCC). Hepatic arterial infusion chemotherapy (HAIC) has been selected as an alternative therapeutic option for advanced HCC. We investigated the efficacy and safety of HAIC as an alternative treatment for sorafenib in advanced HCC. Methods: Between May 2008 and March 2011, 20 consecutive patients were treated with sorafenib monotherapy as a first‐line treatment and 21 consecutive patients who could not take sorafenib because of cost were treated with HAIC monotherapy as an alternative. Sorafenib was administered in 400 mg b.i.d. doses. For HAIC, daily cisplatin (7 mg/m² on days 1–5) and 5‐FU (170 mg/m² on days 1–5) were infused every 4 weeks. We assessed overall survival (OS), progression‐free survival (PFS), objective response rate (ORR) and toxicity. Results: Median OS was 4.9 months (95% CI, 3.4–6.4) for sorafenib and 7.3 months (95% CI, 4.5–10.2) for HAIC (P = 0.599). Median PFS was 2.0 months (95% CI, 1.96–2.05) versus 3.0 months (95% CI, 1.98–4.02) for sorafenib and HAIC, respectively (P = 0.303). ORR and disease control rate (DCR) for sorafenib were 10.0 and 35.0% versus 19.0 and 38.1% for HAIC (ORR, P = 0.413; DCR, P = 0.837). Patients treated with HAIC more frequently exhibited grade 3/4 neutropenia (23.8 vs 0% for sorafenib), whereas sorafenib therapy showed grade 3/4 hand‐foot skin reaction in 10% of patients. Conclusion: HAIC is a useful alternative treatment for advanced HCC and further prospective investigations are required.     

恩度肝动脉灌注联合介入化疗栓塞治疗中晚期肝癌的临床观察

Objective:To study the efficacy and safety of hepatic arterial infusion of Endostatin(YH-16,Endostar),combined with transcatheter arterial chemoembolization(TACE) on advanced hepatocellular carcinoma.Methods:Thirty patients with advanced hepatocellular carcinoma were enrolled in the study.The patients received hepatic arterial infusion of Endostar combined with TACE.The efficacy was evaluated strictly after 1-2 cycles according to RECIST criteria and the value of AFP;quality of life(QOL) was evaluated according to Karnofsky scores.Adverse effects were evaluated too.Results:29 cases' efficacy was evaluated among the total 30 cases.The KPS were significantly increased after the treatment(80.39 ± 8.37 vs 73.93 ± 9.22,P = 0.002).Compared with control group,the objective response rate(CR and PR) and the rate of AFP negative changed were significantly higher(P = 0.021,P = 0.046).The adverse effects were not obvious.Conclusion:The QOL and preliminary efficiency of patients of advanced hepatocellular carcinoma may be improved by hepatic arterial infusion of Endostar combined with TACE,the rate of AFP negative changed were significantly higher too,and there are little of adverse effects.It is worthy to clinical generalization and further clinical observation.     

动脉灌注健择治疗中晚期胰腺癌

目的 评价经动脉灌注健择治疗中晚期胰腺癌的疗效。方法 36例患者共行65次经动脉内灌注健择，药量按800～1200mg／m^2，间隔2～4周给药一次。结果 以疾病相关症状改善(DRSI)作为评价近期疗效依据，其中以疼痛改善最为显著。结论 经动脉内灌注健择是治疗中晚期胰腺癌的有效方法，可改善临床症状，提高生存质量。     

Repetitive short-course hepatic arterial infusion chemotherapy with high-dose 5-fluorouracil and cisplatin in patients with advanced hepatocellular carcinoma

BACKGROUND: Hepatic arterial infusion chemotherapy (HAIC) has often been selected as a therapeutic option for patients with advanced hepatocellular carcinoma (HCC). The objective of the current study was to evaluate the efficacy and safety of repetitive HAIC with high-dose 5-fluorouracil (5-FU) and cisplatin given for 3 days in patients with advanced HCC. METHODS: Between January 2001 and December 2004, a total of 41 patients with unresectable advanced HCC were enrolled. The patients underwent HAIC via the implantable port system with 5-FU (at a dose of 500 mg/m(2) on Days 1-3) and cisplatin (at a dose of 60 mg/m(2) on Day 2) every 4 weeks. Tumor response was assessed at the end of every 3 cycles. RESULTS: The median age of the patients was 53 years and 34 patients (82.9%) had evidence of portal vein thrombosis. In total, 230 cycles of HAIC were administered to the 41 patients, with a median of 6 cycles given (range, 1-14 cycles). Nine patients (22.0%) achieved a partial response and 14 patients (34.1%) had stable disease. The median time to disease progression and overall survival were 7.0 months and 12.0 months, respectively. The overall survival was found to be significantly longer in the successful disease control group (patients with a complete response, partial response, and stable disease) than in the disease progression group (median of 14.0 months vs 6.0 months; P < .001). Adverse reactions were tolerable and successfully managed with conservative treatment. CONCLUSIONS: HAIC with high-dose 5-FU and cisplatin given for 3 days achieved effective and safe results in patients with advanced HCC. Therefore, repetitive short-course HAIC with high-dose 5-FU and cisplatin may be useful as an alternative therapeutic option for patients with advanced HCC.     

动脉灌注结合全身静脉化疗治疗中晚期胰腺癌的临床观察

目的:观察动脉灌注结合全身静脉化疗治疗中晚期胰腺癌的疗效。方法:对12例中晚期胰腺癌患者选择性给予腹腔干动脉和/或肠系膜上动脉灌注吉西他滨和5-氟尿嘧啶,第8天再给予吉西他滨全身静脉化疗。3周为1个治疗周期,完成两个周期后复查CT评价疗效,观察临床受益反应、有效率、生存期及毒副反应。结果:全组患者临床受益率66.7%,有效率(CR PR)16.7%,中位生存时间6.7个月,6个月及9个月累积生存率分别为59.4%、29.6%。毒副反应多为Ⅰ°～Ⅱ°均能耐受。结论:动脉灌注结合全身静脉化疗治疗中晚期胰腺癌可获得较好的疗效,提高生存质量,毒副反应较小,值得临床推广应用。