TACE联合FOLFOX4方案治疗中晚期肝细胞癌的临床观察

目的:观察经导管肝动脉化疗栓塞术(TACE)联合FOLFOX4方案对中晚期肝细胞癌的疗效及不良反应。方法:回顾性分析2010年7月-2011年1月入住我院无法手术切除的中晚期肝细胞癌患者37例。每位患者行TACE至少2次,术后给予FOLFOX4辅助化疗:奥沙利铂85mg.m~(-2),静脉滴注2h,第1天;亚叶酸钙200mg.m~(-2),静脉滴注2h,第1、2天;5-氟尿嘧啶400mg.m~(-2),静脉推注后,以600mg.m~(-2)持续静脉滴注22h,第1、2天。每3周为1个周期。随访半年,评估疗效及不良反应。结果:治疗3月后,有效率为48.6%,肿瘤控制率为81.1%。不良反应为Ⅰ～Ⅲ度,经对症处理后可缓解。结论:TACE联合FOLFOX4方案治疗无法手术的中晚期肝细胞癌可获得较好有效率及肿瘤控制率,且不良反应可耐受。

Clinical Observation of FOLFOX4 Adjuvant Chemotherapy Combined with Transcatheter Arterial Chemoembolization in the Treatment of Advanced Hepatocellular Carcinoma

OBJECTIVE：To observe the therapeutic efficacy and adverse drug reaction of FOLFOX4 combined with transcatheter arterial chemoembolization（TACE）in the treatment of advanced hepatocellular carcinoma.METHODS：37 patients with advanced hepatocellular carcinoma,who were admitted to our hospital from Jul.2010 to Jan.2011,were analyzed retrospectively.Transcatheter arterial chemoembolization（TACE）was performed at least twice for each patient.FOLFOX4 adjuvant chemotherapy was given after TACE procedure：oxaliplatin at the dose of 85 mg·m^-2,intravenous drip infused for 2 hours at the first day of treatment;calcium folinate at the dose of 200 mg·m^-2,intravenous drip infused for 2 hours at the first and the second day of treatment;5-fluorouracil at the dose of 600 mg·m^-2,intravenous drip infused for 22 hours after intravenous push with the dose of 400 mg·m^-2at the first and the second day of treatment.Therapy was repeated every 3 weeks.The efficacy and adverse drug reactions were evaluated after half year＇s follow-up.RESULTS：The overall response rate was 48.6%,and the disease control rate was 81.1%.Adverse drug reactions were gradeⅠto Ⅲ,released after corresponding treatments.CONCLUSION：FOLFOX4 adjuvant chemotherapy combined with TACE is optimal in the treatment of advanced hepatocellular carcinoma in effective rate and disease control rate,with tolerable side effects.