肝动脉插管大剂量顺铂“双路化疗”治疗晚期肝癌

自1986年3月至1988年3月,对25例经病理证实的原发性肝细胞癌及5例转移性肝癌进行了经股动脉插管至肝动脉大剂量顺铂灌注,全身经静脉给硫代硫酸钠解毒的“双路化疗”,顺铂剂量,第一疗程为80～100mg/m~2,第二疗程为120～150mg/m~2加硫代硫酸钠解毒。治疗前后水化及甘露醇利尿。结果:经体检、B超、CT、肝血管造影复查,25例原发性肝癌中,12例肿块缩小25～50％或造影显示肿块供血主干变细,瘤体血管减少,部分血管闭塞,肿块缩小,肿瘤内出现坏死,呈低密度透亮区。5例转移性肝癌,4例出现上述改变,总有效率为53％(16/30)。毒性反应不严重,无严重肾毒性及白细胞减少。

"Two-Route Chemotherapy" of lA High Dose Cisplatin and IV Sodium Thiosulfate (STS) for Advanced Liver Cancer

From Mar. 1986 to Mar. 1988, 25 patients with primary and 5 with metastatic hepatic carcinoma were treated with IA high dose DDP and IV STS. Each patient was given one or two courses of treatment. The dosage of DDP was 80-100mg/m~2 at the first course and 120-150mg/m~2 at second course. STS was given.intravenously and simultaneously as a protective agent. Hydration and mannitol administration was necessary before and after DDP treatment. Of 25 patients with primary liver cancer, 12 had tumor mass shrinkage by 25-50% of the pretreatment size. Angiographic examination showed tumor shrinkage, necrosis, narrowing or obliteration of tumor feeding vessels, and/or avascularity. Four of 5 metastatic carcinomas also responsed. The overall response rate was 53% (16/30). Toxicity was mild. No serious nephrotoxicity or leukopenia occurred during treatment.