沙利度胺对原发性肝癌介入栓塞术后血管生长因子的影响

目的 本研究旨在评价沙利度胺对原发性肝癌介入栓塞术后血管生长因子的影响,探索以介入治疗为主的中晚期肝癌的综合治疗模式.方法 以肝动脉栓塞术前1周内及术后30天血管内皮生长因子水平为观察终点指标,并观察沙利度胺的不良反应.采用前瞻性随机对照研究,对2006年2月～2006年8月就诊我科的68例原发性肝癌患者随机分为治疗组和对照组,治疗组给予沙利度胺200 mg/d口服1～6个月联合TACE,对照组单纯行TACE.TACE用药选用吉西它滨0.4～1.6 g、奥沙利铂100～200 mg、氟脲嘧啶脱氧核苷 0.5～1.0 g, 栓塞剂选用碘化油、明胶海绵.以双抗夹心ELISA法检测血VEGF水平.结果 介入治疗后两组患者的VEGF水平均有升高,但联合沙利度胺组VEGF升高幅度明显低于单纯介入栓塞组,两组有显著性差异(P《0.05).结论 口服沙利度胺可降低原发性肝癌介入栓塞术后的血管内皮生长因子水平,提示沙利度胺联合TACE可能进一步提高原发性肝癌介入栓塞治疗的效果.

The changes of vascular endothelial growth factor after treatment of thalidomide combined with TACE for HCC

Objective This study was to evaluate the changes of vascular endothelial growth factor after treatment of thalidomide combined with TACE for HCC.Methods The end point is vascular endothelial growth factor(VEGF) levels a week before TACE and 30 days later.The side effects of thalidomide were observed.Serum VEGF levels were determined by enzyme-linked immunosorbent assay(ELISA).From Feb.2006 to Aug.2006,68 patients with unresectable primary HCC were randomized into combination group(TACE plus thalidomide) and TACE group.Combination group received oral administration of thalidomide(200 mg/d) for 1-6 months.Both groups were treated with 0.4-1.6 gemcitabine,100-200 mg oxaliplation,and 0.5-1.0 floxuridine as chemotherapeutic drugs,ethanol,glutin,and iodolipol as ambolic agent in TACE.Results Serum VEGF levels were increased in both groups after TACE,but significantly in TACE group(<0.05).Conclusion Oral administration of thalidomide can depress serum VEGF levels after TACE,Which suggest TACE plus thalidomide can improve efficacy of TACE on HCC,obviously postpone disease progress and prolong survival of HCC patients.The times of TACE are the prognostic factors for patients with HCC after TACE.