甲地孕酮联合介入治疗提高中晚期原发性肝癌患者生活质量的临床研究

Megestrol Acetate plus Interventional Therapy for Improving Quality of Life for Patients with Intermediate and Advanced Primary Hepatic Carcinoma:A Clinical Study

目的:观察甲地孕酮(艾诺克,MA)联合介入治疗中晚期原发性肝癌患者的生活质量及毒副作用。方法:60例原发性肝癌患者随机分为两组,研究组(A组)30例,应用MA+肝动脉化疗栓塞术(TACE)联合治疗;对照组(B组)30例,单纯应用TACE。结果:A组与B组近期疗效比较,A组有效率30%(9/30),B组有效率23.3%(7/30),两组无显著性差异P>0.05。A组食欲改善80%(24/30)、体重增加66.7%(20/30)、KPS评分增加86%(26/30)、胃肠道无反应80%(24/30)、骨髓抑制0度73.3%(22/30);B组分别为20%(6/30)、16.7%(5/30)、20%(6/30)、40%(12/30)、16.7%(5/30)。两组比较有显著性差异P<0.01,并未见明显不良反应。结论:TACE联合MA小剂量40mg,每日2次,治疗原发性肝癌,剂量安全可行,并能明显改善患者的生存质量,并有一定的保护骨髓的作用,值得临床推广应用。

OBJECTIVE： To observe the efficacy and toxicity of Megestrol Acetate （MA） combined with interventional therapy for intermediate and advanced primary hepatic carcinoma. METHODS： A total of 60 patients with primary hepatic carcinoma were randomly assigned to receive MA plus hepatic arterial chemoembolization （HACE） （ n = 30, trial group/ group A） or TACE alone （n = 30, control group/ group B）. RESULTS： In terms of short- term efficacy, there were no significant differences between group A and group B in the response rate [30% （9/30） vs. 23.3% （7/30）] （P 〉 0.05）. In group A, the appetite improvement, weight gain, increase of KPS score, gastrointestinal reaction - free and 0 degree depression of bone marrow appeared in 80% （24/30）, 66.7% （20/30）, 86% （26/30）, 80% （24/30） and 73.3% （22/ 30） of the cases, respectively versus 20% （6/30）, 16.7% （5/30）, 20% （6/30）, 40% （12/30）and 16.7% （5/30） respectively in group B, and the differences between these two groups were statistically significant （ P 〈 0.01）. No obvious side reactions were noted. CONCLUSION： Low dose MA （40mg bid） combined with TACE was proved to be safe and feasible for primary liver cancer and effective in significantly improving the life quality of patients in addition to its protective effect on bone marrow, which thus deserving to be popularized in clinical practice.