节拍性化疗联合ＴＡＣＥ治疗原发性肝癌的临床观察

目的：探讨节拍性化疗（ｍｅｔｒｏｎｏｍｉｃｃｈｅｍｏｔｈｅｒａｐｙ）联合肝动脉化疗栓塞（ＴＡＣＥ）对原发性肝癌（ＰＨＣ）的疗效及毒副反应。方法：经临床诊断的原发性肝癌４１例患者分为Ａ、Ｂ两组。Ａ组２１例，ＴＡＣＥ间歇期接受节拍性化疗，即每次ＴＡＣＥ术后１周给予替加氟１００ｍｇ口服，每日１次；环磷酰胺５０ｍｇ口服，每日１次，持续口服２～３周，休息１周；２～３次ＴＡＣＥ术后，持续节拍性化疗３～４个月。Ｂ组２０例，仅用ＴＡＣＥ治疗。每月复查血常规、肝功能、Ｂ超、ＣＴ和ＡＦＰ等，并评价疗效。结果：Ａ、Ｂ两组患者中位生存期分别为１８个月和１２个月，Ａ组近期疗效为７６％，Ｂ组近期疗效为４５％，差异有显著性（Ｐ＜００５）。Ａ组１年存活率为6０％，Ｂ组为３３％，两组差异显著（Ｐ＜０.０５）。两组毒副反应相似，无显著性差异。结论：采用ＴＡ-ＣＥ联合节拍性化疗治疗原发性肝癌，能够提高近期疗效，且不增加毒副反应。

Clinical study of TACE combined with metronomic chemotherapy for primary liver cancer

Objective ： To study the effect and toxicity of metronomic chemotherapy combined with transcatheter arteria chemo- embolization（TACE） in patients with primary liver cancer（PHC）. Methods：Forty-one cases of PHC were randomly divided into two groups. Group A（ n = 21 ） were treated with TACE combined with metronomic chemotherapy, and group B （n = 20） were treated with TACE alone. All these patients were followed up with AFP test, Ultrasound and CT in one month. Results：The median survival period was 18 months in combination group and 12 months in TACE group. The short-term therapeutic effect was 76% in group A, and 45% in group B. There was a significant difference between them. The survival probability of one year of group A was 60% , while group B was 33%. There was also a significant difference between them. Conclusion：The therapy of TACE combined with metronomic＇, chemo- therapy could increase the short-term therapeutic effects while not raise the toxicity.