TACE术联合EOF方案系统治疗中晚期原发性肝癌的临床研究

目的评价TACE术联合EOF方案系统治疗中晚期原发性肝癌的疗效和不良反应。方法 A组为对照组,32例,单纯行肝动脉化学栓塞术。B组为治疗组,26例,肝动脉化学栓塞术2次后行EOF方案全身静脉化疗,直到病情进展或不适宜继续治疗及出现不可耐受的不良反应。B组肝动脉栓塞术后4-6周开始行EOF方案化疗,即：吡柔比星40 mg/m2d1,澳沙利铂OXA 85 mg/m2d-1.8,5-FU 0.5g/m2d1-5。28 d为1个周期,连用2个周期后评价疗效。结果 A、B两组的总有效率（RR率）为37.5%vs61.5%,疾病控制率（DCR率）为84.39%vs96.1%,1年生存率50%vs88.4%,2年生存率18.7%vs61.5%,3年生存率12.5%vs19%。主要不良反应为骨髓抑制,IV°不良反应少见。结论 TACE术联合EOF方案系统治疗中晚期原发性肝癌能显著提高有效率和1年、2年的生存率,不良反应可以耐受,依从性高,可作为中晚期原发性肝癌的一种有效的治疗模式。

Clinical Research on Advanced Primary Liver Cancer under Systemic Treatment of TACE Combined with EOF Regimen

Objective To evaluate the treatment efficacy and toxicity of advanced primary liver cancer under the systemic treatment of TACE combined with EOF regimen. Methods Transcatheter arterial ehemoembolization was given to 32 cases in group A （control group）. Systemic venous chemotherapy with EOF regimen was given to 26 cases in group B（treatment group） after they underwent transcatheter arterial chemoembolization for 2 times until the disease progressed or the patients were not appropriate to continue the treatment or the toxicity was intolerable. 4-6 weeks after transcatbeter arterial chemoembolization, group B began to undergo chemotherapy with EOF regimen, namely, the detailed regimen is pirarubiein 40 mg/m2 dl, oxaliplatin （OXA） 85 mg/m2 dl-8, 5-FU 0.5 g/m2 d1-5. The evaluation of treatment efficacy should be given after 2 continuous circles based on 28 days per circle. Results The overall response rate （RR） in group A is lower than that in group B （37.5% VS 61.5%）, disease control rate （DCR） is lower than that in group B（84.39% VS 96.1%）, 1-year survival rate is lower than that in group B（50% VS 88.4%）, 2-year survival rate is lower than that in group B （18.7% VS 61.5%）, 3-year survival rate is lower than that in group B （12.5% VS 19%）. The primary toxic side effect is bone marrow suppression, IV° adverse reactions are seldom reflected. Conclusion For advanced primary liver cancer, systemic treatment of TACE combined with EOF regimen can obviously improve the efficacy and 1-year and 2-year survival rate with tolerable side effects and high compliance. It could be an effective treatment pattern for advanced primary liver cancer.