莪术油和化疗药对照肝动脉灌注栓塞治疗原发性肝癌的临床研究

A Controlled Clinical Study between Hepatic Arterial Infusion with Embolized Curcuma Aromatic Oil and Chemical Drugs in Treating Primary Liver Cancer

目的 :评价莪术油肝动脉灌注栓塞治疗原发性肝癌的疗效、毒副作用及应用前景。方法 :用莪术油 1～ 3ml经动脉插管至肝动脉灌注栓塞治疗原发性肝癌 32例 ,与同期用化疗药灌注栓塞治疗的 32例作对照观察。两组均按辨证施治同时服用中药。结果 :治疗组CR 1例 ,PR 13例 ,总有效率为 4 3 75% ( 14/32 ) ;甲胎球蛋白 (AFP)转阴 7例 ,滴度下降 7例。化疗组PR 10例 ,有效率为 31 2 5% ( 10 /32 ) ;AFP转阴 5例 ,滴度下降 2例 ,两组疗效比较差异无显著性 (P >0 0 5)。治疗后出现灌注栓塞综合征 (发热、腹痛、呕吐等 )两组相似 ;但治疗组无明显骨髓抑制现象 ,两组比较差异有显著性 (P <0 0 1或P <0 0 5)。治疗组平均生存期 11 5个月 ,中位生存期 10个月 ;1、2、3年生存率分别为 37 5% ( 12 /32 )、13 3% ( 4 /30 )、6 9% ( 2 /2 9)。化疗组平均生存期 7 2 5个月 ,中位生存期 6个月 ;1、2、3年生存率分别为 15 6% ( 5/32 )、3 2 % ( 1/31)、0。治疗组平均生存期、中位生存期、1年生存率均明显优于化疗组 (P <0 0 5)。结论 :莪术油肝动脉灌注栓塞治疗原发性肝癌疗效与化疗药相似 ,但生存时间和骨髓抑制明显优于化疗药。

Objective: To evaluate the effectiveness, toxicity and prospective application of hepatic arterial infusion (HAI) with Embolized Curcuma Aromatic oil (CAO) in treating primary liver cancer (PLC). Methods: In the treated group, 32 patients with PLC were treated by HAI with 1～3 ml of embolized CAO and oral administration of Chinese herbal medicine. In the control group, 32 patients with PLC were treated with transcatheter artery chemoembolization (TACE). Results: In the treated group, one patient attained complete remission (CR) and 13 partial remission (PR), the total effective rate being 43.75%. The level of alpha fetal protein (AFP) turned to normal range in 7 cases and decreased in other 7. In the control group, 10 obtained PR and the total effective rate being 31.25%, AFP level turned to normal in 5 and decreased in 2. There was no statistical significance between the two groups. The incidences of post embolism syndrome, such as fever, abdominal pain and vomiting were similar between the two groups but no myelosuppression occurred in the treated group with significant difference (P<0 01) as comparing with that in the control group. The mean survival time, median survival time, 1 , 2 and 3 year survival rate in the treated group was 11.5 months, 10 months, 37.5%, 13.3% and 6.9% respectively, while in the control group was 7.25 months, 6 months, 15.6%, 3.2% and 0 respectively. The treated group was better in mean survival time, median survival time and 1 year survival rate than that of the control group (P<0 05). Conclusion: HAI with embolized CAO showed a similar favorite effect in treating PLC as that of TACE, but superior than TACE with longer survival time and milder myelosuppression.