含奥沙利铂与含顺铂方案肝动脉栓塞化疗治疗中晚期肝癌的疗效

Clinical effect of oxaliplatin-containing and cisplatin-containing regimen in TACE of advanced hepatocellular carcinoma

目的分析含奥沙利铂（L—OHP）与含顺铂（DDP）方案行肝动脉化疗栓塞术（TACE）对中晚期原发性肝癌（HCC）的治疗效果和不良反应。方法将108例中晚期HCC患者随机分成2组。治疗组55例，行含L—OHP方案介入治疗，L—OHP 130mg／m^2，替加氟（FT207）500～750mg／m^2，用葡萄糖溶液稀释后分别注入血管，根据肿瘤病灶的大小以多柔比星（ADM）40mg／m^2＋超液化碘油10～30ml乳化后进行血管栓塞。对照组53例，行含DDP方案介入治疗，DDP40mg／m^2，FT207500～750mg／m^2，用葡萄糖溶液稀释后分别注入血管，根据肿瘤病灶的大小以ADM40mg／m^2＋超液化碘油10～30ml乳化后进行血管栓塞，并予水化利尿。结果治疗组近期有效率为67.3％（37／55），与对照组[47．2％（25／53）]比较，差异有统计学意义（P〈0．05）。治疗组甲胎蛋白（AFP）下降率为73．1％（31／43），与对照组[44．7％（17／38）]比较，差异有统计学意义（P〈0．05）。主要不良反应为消化道反应，治疗组恶心、呕吐发生率较对照组低，差异有统计学意义（P〈0．05）。两组骨髓抑制、肝功能受损、末梢神经炎发生率差异无统计学意义。两组均未见心、肾损害。结论采用以L—OHP为主的方案行TACE治疗中晚期肝癌疗效肯定，安全性好，患者耐受好。

Objective To explore the clinical effect and side-effect of oxaliplatin（L-OHP）-containing regimen and cisplatin （DDP）-containing regimen in TACE of advanced hepatocellular carcinoma （HCC）. Methods 108 patients with advanced HCC were randomly divided into experimental group（n=55） and control group （n =53）. The experimenial group were treated with TACE using L-OHP. After dilute with glucose solution, L-OHP（130 mg/m^2） and FI＇207 （500-750 mg/m^2） were injected into blood vessel respectively. ADM （40 mg/m^2） and LP （10-30 ml） were emulsified and then used for vessel embolism according to the size of focus. The control group received TACE with DDP, DDP （40 mg/m^2） and FT207（500-750 mg/m^2） were diluted with glucose solution, and also according to the size of tumor＇ s focus, ADM（40 mg/m^2） and LP（10-30 ml） were emulsified for vessel embolism, and then diuretic. Results The total effective rate of experimental group was 67.3 % （37/55）, and that of control group was 47.2 % （25/53）, and the difference was with statistical significance （P 〈0.05）. The descent rate of AFP of experimental group was 73.1%（31/43）, and that of control group was 44.7 % （17/38）, and the difference was with statistical significance （P 〈0.05）. The main side effects were gastrointestinal reactions, the incidence rate of nausea and vomiting in experimental group were lower than control group, and the difference was with statistical significance. The incidence rate of leucopenia, damage of hepatic function and peripheral neuritis were not significant. Damage of heart and kidney were not found in the two sets. Conclusion L-OHP -containing regimen in TACE of advanced HCC is an efficient method, with good security and good tolerance to patients.