奥沙利铂及重组人血管内皮抑素经肝动脉灌注联合TACE治疗原发性肝癌

Transhepatic arterial infusion of oxaliplatin and recombinant human endostatin combined with TACE for primary hepatocellular carcinoma

目的观察奥沙利铂及重组人血管内皮抑素联合经肝动脉灌注(TACE)治疗原发性肝癌的疗效及不良反应。方法 2010年6月至2012年6月43例原发性肝癌患者采用TACE术中经肝动脉灌注奥沙利铂及重组人血管内皮抑素治疗,并根据肿瘤血管丰富程度分组,术后观察患者不良反应,并定期行实验室指标及肝脏CT/MRI/DSA评价治疗效果及不良反应。结果富血管肿瘤组治疗的总有效率显著高于乏血管肿瘤组患者(85.7%比33.3%,P<0.05),临床随访数据表明多数富血管的患者通过联合药物灌注治疗有效,生存时间6个月以上者达57.1%(16/28),对于乏血管肿瘤患者的治疗中病情进展的仅为26.7%(4/15)。结论 TACE术中经肝动脉灌注奥沙利铂联合重组人血管内皮抑素治疗原发性肝癌安全有效。

Objective To evaluate the efficacy and side effects of transhepatic arterial infusion of oxaliplatin and recombinant human endostatin combined with TACE in treating primary hepatocellular carcinoma. Methods During the period from June 2010 to June 2012, a total of 43 patients with primary hepatocellular carcinoma were admitted in authors＇ hospital. Transhepafic arterial infusion of oxaliplatin and recombinant human endostatin combined with TACE was carried out in all patients. According to angiographic findings, the patients were classified in hyper-vascularization group （n = 28） and hypo-vascularization group （n = 15）. After the treatment, the patients were kept under close observation for untoward reactions. The laboratory examinations and CT/MRIIDSA were periodically performed to evaluate the efficacy and side effects. The results were statistically analyzed and compared between the two groups. Results Clinical effective rates of hyper- vaseularization group and hypo- vascularization group were 85.7% and 33.3% respectively, and the difference between the two groups was statistically significant （P 〈 0.05）. Follow-up findings indicated that the six-month survival rates of hyper-vascularization group were 57.1%（16/28） and the progressive disease rates of hypo-vascularization group were 26.7%（4/15）. Conclusion For the treatment of primary hepatocellular carcinoma, transhepatie arterial infusion of oxaliplatin and recombinant human endostatin combined with TACE is safe and effective.