重组人血管内皮抑素在原发性肝癌化疗栓塞术中的应用

目的探讨重组人血管内皮抑素注射液（恩度）经导管动脉内化疗栓塞（TACE）治疗原发性肝癌的不良反应和近期疗效。方法将临床确诊的66例原发性肝癌患者根据条件相仿原则两两配对分为试验组和对照组。试验组先行常规肝动脉灌注化疗，然后将导管插至肝肿瘤供血动脉，将化疗药、恩度与超液态碘油充分乳化后注入动脉内行栓塞化疗，对照组行常规TACE治疗。两次治疗（间隔1个月）随访观察6个月后评价介入治疗后不良反应和临床近期疗效。结果介入治疗后1周内两组实验室指标的差异无统计学意义（均P〉0.05）；3个月及6个月后两组全身体力状况（KPS）评分、肝功能Child—pugh评分的差异亦无统计学意义（均P〉0．05），肿瘤均明显缩小，差异无统计学意义（P〉0．05）；6个月后试验组肿瘤复发和转移率低于对照组（均P〈0.05）。结论恩度经肝动脉治疗原发性肝癌能降低肿瘤复发和转移率，并且不显著增加不良反应，有临床应用价值。

Application of endostar combined with transcatheter arterial chemoembolization in treatment of primary hepatic cancer

Objective To investigate the short-term efficacy and adverse effect of endostar combined with transcatherter arterial chemoembolization （TACE） in treatment of primary hepatic cancer. Methods Sixty six patients with primary hepatic cancer were randomly divided into two groups： in Group A （endostar group, n=33） patients received conventional TACE first, then emulsified endostar, chemotherapeutic drugs and hyper-liquid iodide oil were infused to tumor via arterial; in group B （control group,n=33）, patients received conventional TACE only. The therapeutic effect and adverse effect of two groups were analyzed after two cycles of interventional treatment. Results There were no difference in liver function within one week and in KPS, hepatic function Child-pugh score after three and six months between two groups. The tumor volume of the two groups was significantly reduced, but there were no differences between two groups （P〉0.05 ）. There were significant differences in recurrence rate and metastasis rate after 6 months between two groups（P〈0.05）. Conclusion Endostar combined with TACE is an effective method to decrease recurrence and metastasis without increasing adverse effect in treatment of primary hepatic cancer.