肝癌患者肝移植术前、术后化疗16例分析

Chemotherapy before and after liver transplantation in 16 cases of hepatocellular carcinoma

目的:探讨肝癌患者肝移植术前、术后使用希罗达+表阿霉素的可行性、安全性及疗效。方法:回顾性研究16例原发性肝癌患者肝移植前后辅助化疗的临床资料。化疗方案为希罗达2500mg/(m·2d),口服,第1￣14天;表阿霉素20mg/m2,静脉滴注,第1￣2天,分析化疗时机、化疗方案、化疗药物的不良反应及近期疗效。结果:16例接受化疗患者存活时间均超过8个月,最长1例24个月;死亡3例,死亡原因为移植肝肿瘤复发和肝内转移及远处转移,化疗不良反应中,12例出现消化道反应,8例发生骨髓抑制,6例出现手足综合征,4例出现肝功能损害,均为轻中度。结论:肝癌患者肝移植术前、术后化疗联用希罗达+表阿霉素是可行的,不良反应可以耐受,可望延长患者存活时间。选择化疗时机可能对肿瘤复发和患者的生存率有影响。

Objective： To investigate the feasibility, reliability and therapeutic effects of chemotherapy for hepatocellular carcinoma （HCC） before and after liver transplantation. Methods： The clinical data of adjuvant chemotherapy before and after liver transplantation in 16 cases of HCC were retrospectively studied. The chemotherapy regime was established as xeloda 2 500/mg（m^2·d）, epirubicin 20 mg/ m^2 iv on day 1 and day 2 , with 28 days as a cycle .The opportune time of chemotherapy, side effects and the effect of chemotherapy on short term survival rate were analyzed. Results： All the cases survived more than 8 months, with the longest survival time of 24 months. Three patients died of metastasis. The side effects of adjuvant chemotherapy were moderate. During the chemotherapy, 12 cases showed digestive effects, 8 cases marrow depression, 6 cases hand-foot syndrome, 4 cases liver functional disorder. Conclusion： The chemotherapy for HCC with xeloda and epirubicin used before and after liver transplantation is feasible and the side effects can be tolerated .It may be expected to prolong the survival time of the patients. The choice of opportune time of chemotherapy might influence the survival rate.