TACE围手术期静脉用三氧化二砷联合^(125)I粒子治疗原发性肝癌的近期疗效研究

The recent therapeutic efficacy of arsenic trioxide by intravenous drip infusion during TACE perioperative combined with ^(125)I particle for the treatment of hepatocellular carcinoma

目的研究经导管肝动脉化疗栓塞术(TACE)围手术期静脉滴三氧化二砷联合125I粒子治疗原发性肝癌的近期疗效。方法选取经临床确诊为原发性肝癌,根据巴塞罗那(BCLC)分期属于B期的患者67例。其中男性55例,女性12例,年龄31～77岁,平均年龄48.3岁。将患者随机分成二组,A组(三氧化二砷+TACE+粒子组)34例,B组(TACE+粒子组)33例,A组入选后静脉滴三氧化二砷,连用14天,间隔14天。静脉滴期间给予TACE及125I粒子治疗,B组行TACE+125I粒子治疗,分别评价其近期疗效,1年生存率,肿瘤复发率,毒副反应。结果 A组与B组近期有效率分别为79.4%和54.5%。两组之间有统计学意义(P<0.05)。A组1年生存率为80.7%,B组1年生存率为75.3%。两组之间无统计学意义(P>0.05)。A组的复发率为5.7%,B组的复发率为24.2%,两组之间有统计学意义(P<0.05)。两组患者出现不同程度的恶心、呕吐、白细胞降低以及谷丙转氨酶升高,在积极对症处理后,症状及各项指标得到有效控制,未出现严重并发症及不良反应,两组之间无统计学意义(P>0.05)。结论 TACE围手术期静脉滴三氧化二砷联合125I粒子植入治疗巴塞罗那(BCLC)分期B期的原发性肝癌,近期疗效好,复发率低,1年生存率高,毒副反应小,安全可靠。

Objective To study the recent therapeutic efficacy of arsenic trioxide by intravenous drip infusion during TA- CE perioperative combined with 125I particles for the treatment of hepatocellular carcinoma. Methods According to Barcelona （BCLC）, 67 patients staging B stage of hepatocellular carcinoma were diagnosed by the clinical diagnosis. 55 cases were male, 12 cases were female, aged from 31 to 77 years old, with an average of 48.3 years. These patients were ran- domly divided into two groups, A and B. There were 34 cases in group A, and 33 cases in group B. Arsenic trioxide by intravenous drip infusion in group A was selected, construe continued for 14 days, interval of 14 days. During the drop peri- od, TACE and 251I particles therapy were given, in group B conbined TACE with 125I particles treatment were given, respectively. We evaluated its curative effect, side response, 1 years of survival rate, tumor recurrence rate. Results The efficacy of group A and group B were 79. 4% and 54. 5% respectively. Two groups had statistical significance （ P 〈0.05）. 1- years survival rate was 80.7% in group A and 75.3% in group B. Two groups had no statistical significance （ P 〉0.05）. The recurrence rate was 5.7% in the group A and 24.2% in the group B. Two groups had statistical significance （ P 〈0.05）. Two groups of patients had different degrees of nausea, vomiting, and decrease of leukocytes, alanine aminotransferase elevation, symptoms and various indicators were effectively controled after symptomatic treatment in the positive way, no serious complications and adverse reaction occurred in the two groups, two groups had no statistical sig- nificance （ P 〉0.05）. Conclusion Arsenic trioxide by intravenous drip during TACE perioperative combined with 125I particle for the treatment of hepatocellular carcinoma staging Barcelona B had good efficacy, low recurrence rate, high 1- year survival rate, low poisonous deputy reaction.