羟喜树碱为主经肝动脉灌注治疗中晚期原发性肝癌的临床疗效

目的观察以羟喜树碱(HCPT)为主行肝动脉栓塞灌注治疗中晚期原发性肝癌的近期疗效及不良反应。方法将58例中晚期原发性肝癌患者随机分为2组。治疗组32例:经皮穿刺股动脉造影后,在肝固有动脉内注射HCPT等药,最后用40%碘化油、阿霉素(ADM)及明胶海绵微粒栓塞近端肿瘤供血动脉。对照组26例:用HCPT为主的联合方案经静脉全身化疗。每4wk重复1次,为一个疗程。2组共完成3～4个疗程。结果治疗组32例患者共接受96次介入治疗总有效率为56.25%,显著高于对照组经静脉全身化疗后的总有效率(26.92%)。2组不良反应主要为骨髓抑制和胃肠道反应,在治疗组和对照组中发生率分别为46.88%、31.25%与84.62%、57.69%(P<0.05)。结论以HCPT为主经肝动脉栓塞灌注治疗中晚期原发性肝癌的近期疗效优于全身静脉化疗,且不良反应小,值得临床研究推广。

Clinical effect of hydroxycamptothecin by perfusion of hepatic artery on intermediate and late primary hepatocarcinoma

AIM To observe the effect and adverse drug reaction of hydroxycamptothecin(HCPT) on intermediate and late primary hepatocarcinoma by perfusion of hepatic artery. METHODS Fifty-eight patients with hepatocarcinoma were classified into 2 groups,treatment group and control group.Thirty-two patients in treatment group were injected HCPT into proper hepatic artery by the puncture of femoral arteriography through the skin and the proximal end of blood-supplying artery to tumor was embolized with 40 percent of iodic oil,adriamycin and grains of gelatin sponge.Twenty-six patients in control geoup were treated with general chemotherapy of HCPT by the way of veins .The patient can be treated again in 4 wk,this was called a course. The both groups were treated for 3 to 4 courses. RESULTS The total effective rate (recent effect )of 32 patients in treatment group reached (CR+PR)56.25%after intercurrent therapy while that of 26 patients in control group amounted to (CR+PR)26.92%.The adverse drug reactions included inhibition of bone marrow and gastroenteric trouble accounting for 46.88%,31.25%and 84.62%,57.69% respectively.The total efficiency in treatment group was superior to that in control group(P<0.05).The incidence of inhibition and gastroenteric trouble was inferior to that in control group(P<0.05).These were significant differences statistically. CONCLUSION This therapy is better than general chemotherapy by veins,with minor dverse drug reactions,and it can be spreaded clinically.