三氧化二砷持续区域肝动脉灌注治疗肝癌的临床研究

Clinical research of arsenic trioxide(As_2O_3) continuous regional hepatic arterial infusion in the treatment of primary hepatic carcinoma

目的探讨三氧化二砷(As2O3)注射液单药连续区域动脉灌注化疗原发性肝癌的临床疗效。方法55例手术不能切除的非晚期原发性肝癌患者,随机分为两组:(1)As2O3治疗组26例:患者采用经股动脉肝动脉碘油栓塞后埋置皮下化疗泵,予以连续区域灌注As2O3化疗,20mg/d,每天1次,共7d,间隔4周重复,共5疗程。(2)对照组29例:采用经股动脉肝动脉栓塞化疗(TACE),2次TACE15例,3次TACE14例。结果As2O3治疗组总有效率为34.6%(9/26)、肿瘤复发率为15.4%(4/26)、1年生存率为80.7%(21/26);TACE组分别是31.0%(9/29)、37.9%(11/29)、51.7%(15/29)。统计学分析表明,两组的总有效率差异无统计学意义,P>0.05;肿瘤复发率和1年生存率差异有统计学意义,P<0.05。As2O3治疗组较对照组不良反应轻微,未见不可逆不良反应。结论经股动脉肝动脉碘油栓塞后埋置皮下化疗泵予以连续区域灌注As2O3化疗用于治疗原发性肝癌不良反应轻微、疗效确切,具有一定的临床应用前景。

Objective To investigate the clinical efficacy of arsenic trioxide （ As2O3 ） continuous regional arterial infusion chemotherapy in the treatment of primary hepatic carcinoma （ PHC ）. Methods Fifty-five patients with unreseetable non-advanced primary hepatic carcinoma were randomly divided into two groups. Twenty-six eases in group As2O3 treatment post hepatic artery lipiedol embolism received continuous regional infusion As2O3 chemotherapy through the chemotherapy pump placed beneath the skin by femoral artery transeatheter, 20 mg/d,qd×7, and the treatment repeated every four weeks with a total of 5 courses. Twenty-nine eases in group TACE received femoral TACE,among whom 15 eases receives TACE twice and 14 eases received 3 treatments. Results In the group As203 treatment ,objective response rate was 34.6% （9/ 26） ,the first time recurrence rate was 15.4% （4/26）, and 1-year survival rate was 80.7% （21/26）. In the group TACE,they were 31.0% （9/26） ,37.9% （11/29） and 51.7% （15/29） respectively. Between two groups, objective response rate was not. significantly different , P 〉 0. 05 ; the differences of the first time recurrence rate and 1-year survival rate were significantly different, P 〈0.05. The group As203 treatment had little toxicity, and no irreversible toxic response occurred. Conclusions As2 03 continuous regional infusion chemotherapy post hepatic artery lipiodol embolism through the chemotherapy pump placed beneath the skin by femoral artery transeatheter is effective and safe in the treatment of PHC, which has wide clinical application perspective.