肝动脉灌注结合全身化疗治疗进展期肝内胆管细胞癌的效果观察

Effect of hepatic artery infusion combined with systemic chemotherapy in the treatment of advanced intrahepatic cholangiocarcinoma

目的:评估肝动脉灌注结合全身化疗治疗进展期肝内胆管细胞癌的疗效。方法:将41例肝内胆管细胞癌患者按治疗方法不同分为灌注组和单纯化疗组。灌注组22例经肝动脉灌注5-Fu和顺铂,同时给予吉西他滨静脉滴注;单纯化疗组19例给予吉西他滨和顺铂静脉滴注。对比分析两组疗效。结果:灌注组CR 1例,PR 7例,SD 9例,有效率38.0%,获益率80.9%;单纯化疗组无CR患者,PR 5例,SD 5例,有效率26.3%,获益率52.6%。两组获益率间差异有统计学意义(P=0.036)。灌注组Ⅱ度骨髓抑制率为31.8%(6/22),与单纯化疗组63.2%(12/19)相比,差异有统计学意义(χ2=84.35,P=0.021)。两组中位生存时间分别为15.6月和10.9月,经Log-rank检验,差异有统计学意义(P<0.05)。结论:肝动脉灌注加全身化疗对晚期肝内胆管细胞癌有较好的疗效,且不良反应较少,可作为此类患者的治疗选择。

Objective： To evaluate the effect of hepatic artery infusion combined with systemic chemotherapy for advanced intrahepatic cholangiocarcinoma（ICC） patients.Methods： Forty-one cases with advanced ICC were divided into group hepatic artery infusion（HAI） and group GP,which had been taken treatment of HAI＋gemcitabine（GEM） or GP chemotherapy respectively.Results： In group HAI＋GEM,complete response（CR） was 1 case,partial response（PR） was 7 cases,and stable disease（SD） was 9 cases.Meanwhile,ORR was 38.0% and CBR was 80.9%.In group GP,there was no CR,and PR was 5 cases,SD was 5 cases,ORR was 26.3%,and CBR was 52.6%.There was significant different of CBR between the two groups.There was a significantly lower rate of Grade 2 bone marrow suppression in the group HAI＋GEM（31.8%）,compared with the GP group 63.2%,and median overall survival time was 15.6 months and 10.9 months respectively with a statistically difference（P0.05）.Conclusion： There was better efficacy and lower side effect of the treatment with advanced cholangiocarcinoma and HAI＋GEM chemotherapy,so the comprehensive treatment can be used for these patients.