沙利度胺联合肝动脉栓塞化疗治疗中晚期原发性肝癌

目的探讨沙利度胺联合肝动脉栓塞化疗（TACE）治疗原发性肝癌的疗效及安全性。方法将入组的中晚期原发性肝癌患者76例随机分观察组42例和对照组34例。观察组在肝动脉栓塞化疗的基础上加沙利度胺口服,剂量由100mg/d递增至200mg/d或300mg/d,直至出现病情进展或无法耐受副作用止;对照组仅行肝动脉栓塞化疗。结果观察组和对照组的中位肿瘤进展时间（TTP）分别为6.8个月（95%CI3.5～9.2个月）和3.1个月（95%CI1.3～4.7个月）,二组差异有统计学意义（P〈0.05）。观察组和对照组的中位总生存期分别为19个月（95%CI11～27个月）和12个月（95%CI9～14个月）,二组差异有统计学意义（P〈0.05）。6,12,18,24个月观察组和对照组的生存率分别为90.5%（38/42）、76.2%（32/42）、66.7%（28/42）、38.1%（16/42）和79.4%（27/34）、50%（17/34）、29.4%（10/34）、20.6%（7/34）,χ^2值（P值）分别为2.05（P〉0.100）、5.78（P〈0.25）、10.41（P〈0.005）、4.26（P〈0.05）。主要毒副作用为便秘、嗜睡,均轻微,对症处理或减药后可缓解。结论沙利度胺联合肝动脉栓塞化疗,能延长原发性肝癌患者生存,毒副作用轻微。

THALIDOMIDE COMBINATION TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION IN PRIMARY LIVER CANCER

Objective To evaluate the efficacy and safety of thalidomide（TLD） combined transcatheter arterial chemo- embolization（TACE） in primary liver cancer. Methods 76 patients with primary liver cancer were randomly divided into therapy group and control group, 42 cases in therapy group were received TLD for oral administration base on TACE, dose of TLD was 100 mg/day at first,and then increased to 200 mg or 300 mg per day, until the disease progression or toxicity had become intolerable. 34 patients in control group only received by TACE. Results The median time tO disease progression was 6.8 months （ 95% CI 3.5-9.2 months ）in therapy group and 3.1 months （ 95% CI 1.3 - 4. 7 months） in control group, it had significant difference between the two groups （P〈0.05）. the median total survival time were 19 months（ 95% CI.- 11 - 27 months） and 12 months （95% CI; 9 - 14 months ）, it was significant between the two groups （P〈0.05）. The survival rate were 90. 5% （38/42）,76.2% （32/42） ,66.7%（28/42） ,38.1% （16/ 42）and 79.4%（27/34） ,50%（17/34） ,29.4% （10/34） ,20.6% （7/34） at 6 month 12 month 18 month 24 month in the two groups, respectively. χ^2 （P） values were 2.05（P〉0. 100） ,5.78（P〈0.25）,10. 41 （P〈0. 005）,4.26（P〈0. 05）. Adverse events included coprostasis and sleepiness,but was mild and reversible. Conclusion It can delay survival time of primary liver cancer by thalidomide combination transcatheter arterial chemoembolization and less toxic effects.