培他滨在中晚期肝癌中的临床应用

目的探讨卡培他滨联合肝动脉插管化疗栓塞（TACE）在中晚期肝癌患者中的临床应用。方法中晚期肝癌患者随机分为两组，治疗组20例，对照组40例。治疗组采用TACE一周后，服用卡培他滨每日2．0g／m2，分2次口服，服用2周，停用2周为1个疗程。对照组采用单纯TACE治疗，两组中TACE治疗每月1次。结果治疗组20例患者中完全缓解（CR）0例，部分缓解（PR）13例，无变化（SD）6例，恶化（PD）1例，总有效率为65．0％。甲胎蛋白（AFP）下降率为60．0％，肿瘤缩小率为70．0％，中位生存期为11．5个月。对照组40例患者中，CR0例，PR12例，SD16例，PD12例，总有效率为30．0％，AFP下降率为32．4％，肿瘤缩小率为32．4％，中位生存期为7．6个月。治疗组和对照组手足综合征发生率55．0％和10．0％，骨髓抑制25．0％和22．5％，腹泻15．0％和12．5％，肝脏毒性90．0％和82．5％，以上并发症多为Ⅰ～Ⅱ级，均可耐受，除手足综合征外，其他并发症经过治疗后均恢复正常。结论希罗达联合TACE治疗中晚期肝癌的安全性、疗效，均优于单纯TACE。

Study on Capecitabine Combined For Advanced Liver Cancer

Objective To evaluate the clinical efficacy of capecitabine combined with chemoembolization （TACE） for advanced liver cancer. Methods Forty patients with liver cancer were retrospectively divided into two groups ： Treatment group, on the basis of TACE, 20 patients received oral capeeitabine at 2000 mg/m2 , twice - daily for 14 days followed by 7 - day rest period and repeated in every three week intervals for more than two cycles. Control group, 20 patients received TACE only at 1 - month intervals for at least two cycles. Results In capecitabine and TACE group： there were 0 CR, 13 PR, 6 SD and 1 PD; the overall response rate was 65.0% ; the AFP and tumor reduction rates were 60. 0% and 70. 0% ; the median survival time was 11.5 months. In the TACE only group： there were 0 CR, 12 PR, 16 SD and 12 PD; the overall response rate was 30. 0 % ; the AFP and tumor reduction rates were 32. 4% and 32.4 % ; the median survival time was 7.6months. Comparison of complications： the incidence of hand- foot syndrome of the treatment group and the control group was 55.0% and 10. 0% respectively, the incidence of bone barrow suppression of the treatment group and the control group was 25.0% and 22. 5% respectively, the incidence of diarrhea of the treatment group and the control group was 15.0% and 12. 5% respectively, the incidence of liver toxicity of the treatment group and the control group was 90. 0% and 82. 5% respectively, Most of these toxicities were tolerable at grade 1 -2. Conclusion Capecitabine combined with TACE may be safe and effective for advanced liver cancer and superior to single TACE.