经靶动脉灌注碳酸氢钠提高部分抗肿瘤药物疗效

The increased effect of partial anti-tumor agents by infusing sodium bicarbonate through target artery

目的:经靶动脉向恶性肿瘤组织灌注碳酸氢钠,以调节恶性肿瘤细胞组织的pH值,观察其对白细胞介素- 2 或IFN -α2b和阿霉素介入治疗的增效作用。方法:分层随机抽取37例中晚期原发性肝癌,用Seldinger技术穿刺经股动脉进 入肿瘤动脉血管,碳酸氢钠+rIL- 2/IFN- α2b+阿霉素,药物按一定比例稀释后灌注。介入治疗2个疗程后判断疗效。结果:2 个疗程后总有效率(CR+PR)为76%(28/37)。ⅢA、ⅣA、ⅣB期中位缓解期分别为7、13和6个月,ⅢA、ⅣA、ⅣB期中位生 存期分别为10、14和8个月,ⅢA、ⅣA、ⅣB期生存6个月分别为7、5和3例,ⅢA、ⅣA、ⅣB期生存12个月分别为3、3和2 例,ⅢA、ⅣA、ⅣB期生存24个月分别为1、3和0例,ⅢA、ⅣA、ⅣB期3～4年生存期分别为1、1和1例。白细胞下降Ⅲ级3 例恢复较快。消化道反应Ⅳ级1例、脱发Ⅲ级5例、发热Ⅲ级13例。结论:向恶性肿瘤组织灌注碳酸氢钠可提高白细胞介素- 2、IFN -α2b和ADM的疗效。

Objective:To observe the increased effect of rlL-2, IFN-α 2b and ADM to malignant tumor by infusing sodium bicarbonate through arteries to modify the pH of tumor tissue. Methods:37 patients with advanced primary liver cancer were obtained by stratified random, and sodium bicarbonate rIL-2/IFN-α 2b+chemotherapy drugs were infused into tumor arteries by puncturing femoral arteries with Seldinger technique, all the drugs diluted with certain proportion. The effect was evaluated after 2 cycle treatment.Results:The total effective rate(PR+CR) was 76%(28/37) ;the median remission stages of ⅢA, ⅣA and ⅣB stage were 7, 13 and 6 months respectively ;the median survival of ⅢA, ⅣA and ⅣB stage were 10, 14 and 8 months respectively ; and the cases of 6 month survival of ⅢA, ⅣA and ⅣB stage were 7, 5 and 3 respectively, the cases of 12 month survival 3, 3 and 2, the cases of 24-month survival 1,3 and 0, the cases of 3-year and 4-year survival 1,1 and 1. 3 cases suffered the adverse effect Ⅲ grade leukopenia which could recover rapidly, 1 case Ⅳ grade symptoms of digestive tract, 5 cases Ⅲ grade alopecia and 13 cases Ⅲ grade fever.Conclusion:The curative effect of rIL-2, IFN-α 2b and ADM can be enhanced by infusing sodium bicarbonate into malignant tumor tissue by arterial infusion.