华蟾素动脉给药联合血管栓塞治疗中晚期肝癌的临床研究

目的:探讨中药华蟾素动脉给药联合血管栓塞治疗中晚期肝癌的疗效及其毒副反应、应用前景。方法:50例中晚期肝癌患者随机分为试验组和对照组,试验组予肝动脉灌注华蟾素 碘化油,对照组肝动脉灌注5-Fu Epi-ADM DDP 碘化油,每月重复一次,共治疗2次。结果:试验组CR1例、PR13例、SD10例、PD1例,有效率(CR PR)为56%。对照组CR1例,PR14例,SD8例,PD2例,有效率(CR PR)为60%。试验组AFP治疗后下降率48%,对照组52%,两组近期疗效比较差异无显著性(P>0.05)。试验组1、2、3年生存率分别为64.0%、44.0%和36.7%,对照组1、2、3年生存率分别为60.0%、32.0%和21.0%,但统计学无明显差异(P>0.05)。治疗后对照组出现明显的肝功能损害与骨髓抑制,试验组肝脏与血液系统毒性反应轻微,两组比较差异显著(P<0.01或P<0.001)。结论:华蟾素动脉给药联合血管栓塞治疗疗效与化疗药相似,但对肝功能及骨髓造血影响明显优于常规化疗介入,可作为不适合TACE或TAE肝癌患者治疗的一种有效方法。

Clinical Study on the Treatment of Intermediate and Advanced Stage Liver Cancer with Combination of Arterial Perfusion of Cinobufotalin and Embolotherapy

Objective: To study the efficacy,the toxicity and side effect,and applicative prospect of arterial perfusion of cinobufotalin integrated with embolotherapy on the treatment of intermediate and advanced stage liver cancer.Method: 50 subjects were randomly divided into two groups: treatment group and control group.Cases in the treatment group were administered with cinobufotalin and iodized oil via hepatic arterial infusion/embolization,and to the control group 5-Fu Epi-ADM DDP iodized oil were given for instead,one time per month,twice in all.Result: The response rate(CR PR) was 56%,including 1 CR,13 presented with PR in the former group,compared with 60%(CR PR) in the latter group,including 1 CR,14 PR.After treatment,AFP of the treatment group decrease 48%,the control group 52%,with insignificance between the near time effect of two groups(P>0.05).The 12-month,24-month and 36-month survival rate in the treatment group and control group was 64.0% vs 60.0%,44.0% vs 32.0% and 36.7% vs 21.0% respectively,with insignificance between them(P>0.05).After treatment cases in the control group have obviously had hepatic function damage and bone marrow inhibition,but toxic reaction of liver and hematological system occurred in patients in the treatment group is little,there is noticeable significance between them(P< 0.01 or 0.001).Conclusion: The efficacy of arterial perfusion of cinobufotalin integrated with embolotherapy is resembly alike common chemoemblization,the former is superior to the latter on account of less influence of liver function and bone marrow hematogenesis,It is recommended to be an effective method for liver cancer patients who are unfit for TACE or TAE.