经肝动脉注射抗癌药物加载体溶液治疗中晚期肝癌实验和临床治疗研究

Experimental and Clinical Studies on Anti-cancer Drug Carrier Solution Infused via Hepatic Artery in Treatment of Mid/Late Stage Hepatic Cancers

目的：探讨中晚期肝癌患者的临床治疗。方法：针对中晚期肝癌ＴＡＥ 禁忌证，单一药物灌注性化疗（ＴＡＩ）效果不满意现状，采用海藻酸钠和右旋糖苷做为抗癌药物载体溶液（ＳＡＤ），进行了动物肝脏功能副损害、人体药动学实验和５０ 例ＴＡＥ禁忌证临床治疗研究。结果：１） 与ＴＡＩ比较，ＳＡＤ 有利于提高、延长抗癌药物于肿瘤组织有效浓度和作用时间（Ｐ＜ ０．０１）。２）治疗组１ 年生存率４５．３８ ％ ，平均生存期１１．６９ 个月；对照组１ 年生存率２３．０８％ ，平均生存期６．７４ 年月（Ｐ＜ ０．０１） 。３）ＳＡＤ 在肝动脉释药过程中引起一过性栓塞，但副反应较小，无严重栓塞并发症及死亡病例发生。结论：与ＴＡＩ比较，抗癌药物加ＳＡＤ 更具有积极、有效的治疗作用；临床治疗选择ＳＡ 浓度为６ ％ ～８％ 是安全可行的。

Objective: To study the effect of Sodium Alginate in carrier solution Dextran (SAD) infused via hepatic artery in the treatment of mid/late stage hepatic cancers. Methods: The side effects of this treatment to animal liver function, pharmacokinetics in patients and the contraindication of TAE in 50 cases of hepatic cancer were investigated. Results:1)As compared with transcatheter infusion (TAI), SAD contributed to improve the effective concentration and prolong the acting time of the drug. 2) The one year survival rate of the treatment group was 45.38%and the mean survival time was 11 69 months while those of the control group was 23 08%and the mean survival time 6 74 months ( P<0 01 ) . 3) The release of SAD in hepatic artery could result in a temporary embolism with mild side effect. No serious complications of embolism or death were observed. Conclusion: The results suggest that SAD is superior to TAI and that the safe and feasible SAD concentration ranges from 6%to 8%.