生长抑素类似物联合TACE治疗HCC的临床研究

目的 探讨生长抑素类似物(奥曲肽)联合TACE(肝动脉化疗栓塞术)治疗原发性肝癌(HCC)患者的临床价值.方法 将80例失去手术机会的HCC患者为研究对象,随机分为实验组和对照组各40例.实验组TACE+奥曲肽治疗；对照组行TACE后只给常规护肝治疗,所有患者均行3次TACE治疗,治疗间隔期为1个月.观察两组患者的治疗前后甲胎蛋白(AFP)变化；定期复查腹部CT,测量肿瘤大小,观察有无新生肝癌组织出现,有无肝外远处转移,记录患者一年复发率、肝外转移率和生存率.结果 与对照组相比,实验组AFP降低更明显(P＜0.05)、近期疗效更好(P＜0.05);实验组一年复发率、肝外转移率和生存率分别为22.9％、11.4％、91.4％,对照组分别为46.9％、15.6％、71.9％；两组患者一年肝外转移率差异无显著性(P＞0.05),一年复发率、生存率差异均有显著性(P＜0.05).结论 生长抑素类似物联合TACE治疗无手术机会的HCC患者近期疗效好、一年复发率少、生存率高,值得临床推广.

The clinical research of Somatostatin Analogs with TACE in treatment of Hepatocellular Carcinoma

Objective To investigate the clinical value of Somatostatin Analogs（octreotide） with transcatheter hepatic arterial chemoembolization （TACE） in treatment of hepatocellular carcinoma（HCC）. Methods 80 HCC patients without chance of operation were randomly divided into experimental group and control group, 40 cases of each group. The tumor blood artery were cleared by hepatic artery angiography in experimental group, which were given lipiodol（ 10 - 20 ml ） ＋ pharmorubicin （ 10 - 30 mg） ＋ Hydroxycamptothecin （ 10 - 20 mg ）, then local blood flow slowed down with gelatin sponge particles. After TACE patients received octreotide（0.3 rag/time/day） by continuous intravenous 5 days.Patients in control group were given the conventional protect liver treatment. All of the patients were treated three times, treatment interval for a month. Alpha-fetoprotein（AFP） changed after treatment; Tumor size, new liver cancer organizations and extrahepatic distant metastases were watched by abdominal CT; the recurrence rate, extrahepatic transfer rate and survival rate were calculated. Results Compared with control group, AFP of experimental group reduced more significantly （P〈 0.05）, short-term curative effect was better（P〈 0.05）. The recurrence rate, extrahepatic transfer rate and survival rate respectively was 22.9%, 11.4% and 91.4% in experimental group; 46.9%, 15.6% and 71.9% in control group. The extrahepatic transfer rate of the two groups has no significant difference （P〉 0.05）. The recurrence rate and survival rate of the two groups had significant difference（P〈 0.05）. Conclusion Compared with control group, experimental group has better short-term curative effect, lower recurrence rate and higher survival rate after one year, which have clinical signifi-cance for popularization.