在肝癌治疗中吡柔比星碘油乳剂的应用

The Application of Pirarubicin Lipiodol Emulsion in the Treatment of Hepatic Cellular Carcinoma

对62例肝癌患者使用以吡柔比星碘油乳剂动脉栓塞为主的联合化疗方案。其中9例单发巨块型肿瘤伴外周血象降低者单纯使用吡柔比星碘油乳剂栓塞，l例Ⅲ期肝癌、肝功ChildC级患者仅行导管化疗灌注，3例栓塞后手术切除肿瘤。结果显示近期有效率58％。8例出现胃肠道反应。2例较治疗前WBC明显降低。4例治疗后发生心律异常。9例单纯栓塞患者无ECG或外周血象改变。3例术后病理肿瘤细胞完全坏死。以吡柔比星碘油乳剂栓塞为主的方案毒副作用较低。对血象异常而血供较好的巨块型肝癌患者单纯采用吡柔比星碘油乳剂栓塞，疗效满意并避免了多种化疗药的毒副作用。

Objective: To evaluate the results of the application of pirarubicin lipiodol emulsonin the treatmemt of HCC. Materials and Methods Sixty-two patients suffering from hepatic cellularcarcinoma (HCC) unedrwent embolization therapy with pirarubicin lipiodol emulsion and lor infusionchemotherapy combined. Among them, 9 cases having single huge tumor with hemogram reductionwere treated with pirarubicin lipiodol emulsion embolization. One patient with stage Ⅲ of HCC andgrade C of hepatic function in child classification was treated with transcatheter arterial infusionchemotherapy only. Tumortomy was done on 3 patients after embolization. Results The short--termeffective rate was 58%. Eight cases manifested side effects in gastrointestinal tract. The WBC countreduced markedly in 2 cases. Four cases occurred arrhythmia. Nine patients who only underwent em-bolization had no change both in ECG and hemogram. In the pathological sections,complete tumorcell necroses could be seen in 3 cases after the operation. Conclusion The toxic and side effects of thistherapy is lower. When the hemogram is abnormal but the vascularity is rich,to apply the pirarubicinlipiodol emulsion embolization only to patients with single huge HCC will result in satisfied effectsand avoid toxic and side effects of various chemotherapeutic agents.