奥曲肽在不可切除肝癌治疗中的作用

Therapeutic effects of octreotide in the treatment of unresectable hepatocellular carcinima

目的 观察奥曲肽在不可切除肝癌治疗中的作用和临床效果。方法 选择 2 0 0 0年 1月至2 0 0 2年 12月收治不可切除的原发性肝癌 16例 ,采用肝动脉埋泵化疗加皮下注射奥曲肽治疗 (奥曲肽治疗组 ) ,并与 1995年 1月至 1999年 12月 15例单纯用肝动脉埋泵化疗治疗 (肝动脉化疗组 )和 14例单用静脉全身化疗治疗 (静脉化疗组 )两组病例相对照。结果 奥曲肽治疗组、肝动脉化疗组、静脉化疗组的近期总缓解率分别为 87 5 0 %、73 33%、5 7 14 %。奥曲肽治疗组明显高于静脉化疗组 (χ2 =6 6 96 ,P =0 0 10 )。生存率方面 ,半年生存率分别为 93 75 %、86 6 6 %和 5 7 14 % ,奥曲肽治疗组较高 ;1年生存率分别为 81 2 5 %、4 6 6 7%和 35 71% ,奥曲肽治疗组明显高于肝动脉化疗组 (χ2 =4 0 4 5 ,P =0 0 4 4 )和静脉化疗组 (χ2 =4 6 93,P =0 0 30 )。AFP的总下降率分别为 87 5 0 %、5 3 33%、5 0 0 0 % ,奥曲肽组AFP下降率明显高于其他两组(P =0 0 0 13,P =0 0 0 9)。结论 奥曲肽联合肝动脉埋泵化疗能明显提高不可切除肝癌的缓解率 ,改善病人生活质量 ,延长病人生存期 ,是一种新的有前途的治疗原发性肝癌的手段之一。

Objective To observe the therapeutic effects of octreotide in the treatment of unresectable hepatocellular carcinoma.Methods 16 patients of group A were treated with octreotide intracutaneously,combined with intrahepatic arterial chemotherapy.Group B of 15 cases were treated with intrahepatic arterial chemotherapy;group C of 14 cases,treated with intravenous chemotherapy.Results The rate of complete response(CP) plus partial reponse(CP) of group A,B and C was 87.50%,73.33% and 57.14% respectively.The differenceas between group A and group C was significant(P=0.010).The half-year survival rate of group A,B,C was 93.75%,86.66% and 57.14% respectively.There were significant differences between group A and group C(P=0.018).The one-year survival rate of group A,B,C was 81.25%,46.67%,35.71% respectively.There were significant differences between group A and group B,C.The reduction in AFP level of group A was more significant than that of group B and group C.Conclusion Octreotide administration combined with intrahepatic arterial chemotherapy significantly improves patients survival and quatity of lief,and is a valuable alternative for the treatment of unresectable hepatocellular carcinoma.