碘油阿霉素乳剂导向栓塞化疗治疗中晚期原发性肝癌84例报告

GUIDED CHEMOEMBOLIZATION THERAPY FOR MODERATE AND ADVANCED CARCINOMA OF LIVER USING ADRIAMYCIN LIPIODOL EMULSION (A REPORT OF 84 CASES)

作者自１９８６年以来用碘油阿霉素乳剂（Ａ／Ｌ）导向栓塞化疗治疗中晚期肝癌８４例，并与采用肝动脉或合并门静脉灌注阿霉素的对照组２４例进行比较。结果表明，治疗组症状改善率达８６．１％，ＡＦＰ下降率达７５％，肿瘤缩小率达７９．２％。治疗后平均生存期为１０．３月，明显优于对照组（５．６月）（Ｐ＜０．００１）。半年及１、２、３年累计生存率分别为８９．３％、４３．４％、１３．５％和３．８％，均明显高于对照组（半年５１．２％、１年１１．５％，无２年以上生存者）（Ｐ＜０．０１）。其中３例难以切除之肝癌经本法治疗后获得二期切除，术后生存期明显延长。Ａ／Ｌ灌注后合并明胶海绵中央栓塞的治疗方案可以提高单纯Ａ／Ｌ灌注化疗的疗效。肝癌切除后再插管栓塞化疗不仅可以巩固治疗效果，而且便于观察随访。

We have performed guided chemoembolization on 84 patients of moderate and advanced carcinoma of liver using adriamycin lipiodol emulsion (A/L) since 1986. Result showed that the rate of improvement of symptoms was 86.1%, in75% cases the AFP were decreased and in 79. 2% the size of tumor were reduced. The mean survival time was 10.3 months which was much higer than that of the control group (5. 6 months, P＜0. 001). The survival rates of 1/2, 1, 2, 3 year were 89.3%, 43.4%,13.5% and 3.8% respctively that were significantly higher than those of the control group (51.2%,11.5%,0 ) (P＜0.01). Three patients underwent secondary resection after using A/L chemoem bolization and gelatin sponge central embolization with a longer survival rate. This may be a good method of treatment to the nonresectable liver cancers and may also be an easy way for postoperative observation.