注射用奥曲肽微球在晚期原发性肝癌治疗中的作用

Octreotide microspheres for injection in treating patients with primary advanced hepatocellular carcinoma

目的:观察注射用奥曲肽微球在晚期原发性肝癌病人治疗中的作用。方法:60例晚期原发性肝癌病人,分为2组。对照组30例,男性16例,女性14例,年龄(48±s9)a;治疗组30例,男性18例,女性12例,年龄(47±11)a。均给予对症支持治疗,治疗组同时给予奥曲肽肌内注射,初始予奥曲肽注射液0.1 mg,sc,q 8 h,2 wk后改用注射用奥曲肽微球20 mg,im,每4 wk一次。结果:治疗3 mo后,治疗组肝功能无明显变化,甲胎蛋白(AFP)和血管内皮生长因子(VEGF)下降,CD3,CD4,CD4/CD8均明显升高,CD8明显下降(均P<0.01),对照组除清蛋白外各项肝功能指标损害加重,AFP和VEGF升高,CD3,CD4,CD8和CD4/CD8无变化,2组差异非常显著(均P<0.01)。对照组3,6,12 mo生存率为60%,33%,7%,低于治疗组的87%,67%,40%(P<0.05或P<0.01)。未见明显不良反应。结论:注射用奥曲肽微球可以改善晚期肝癌病人的肝功能和免疫功能,提高生存率和生活质量。

AIM： To observe the effect of octreotide microspheres for injection on treatment of patients with primary advanced hepotocellular carcinoma. METHODS： Sixty patients with advanced primary hepotocellular carcinoma were divided into two groups with 30 patients in the control group （ M 16, F 14 ; age （48 ± s 9 ） a） and other 30 patients in the treatment group （ M 18, F 12 ; age （47 ±11 ） a）. All patients in both groups were under the supporting therapy, but the patients in the treatment group were further treated combined with octreotide injection 0. 1 mg, sc, q8h initially and 2 wk later by octreotide microspheres for injection 20 mg, im, every 4 wk. Patients were followed up monthly and the changes of liver function , T lymphocyte subgroups, serum levels of alpha-fetoprotein （AFP）, vascular endothelial growth factor （VEGF） , the size of the tumor mass, the accumulative survival rate and the quality of the life were observed. RESULTS ： After 3 mo treatment, liver function did not change obviously in the treatment groupbut with decrease of AFP, CD3, CD4, CD4/ CD8 （ VEGF, CD8 and increase of P 〈 0.01 ）. The liver function except albumin impaired, the levels of AFP, VEGF increased but with no obviously changes of CD3, CD4, CD8, CD4/ CD8 in the control group. There were significant difference between the two groups （P 〈0.01 ）. The accumulative survival rate of 3, 6, 12 mo in the control group were 60 %, 33 %, 7 % and those in the treatment group were 87 %,67 %, 40% （P〈0.05 or P〈0.01）. The improvements of the accumulative survival rate and the quality of life were conspicuous in treatment group （P 〈 0.05 ）. No decreases of the tumor mass and obvious adverse reactions were observed. CONCLUTION： The administration of octreotide microspheres for injection appears to improve the liver function, immunity, survival rate and the quality of life in patients with advanced hepatocellular carcinoma.