经药盒导管系统化疗栓塞治疗肝癌及相关药物监测

Effect of chemoembolization via port-catheter system on hepatic carcinoma

目的 探讨经药盒导管系统 (PCS)化疗栓塞治疗肝癌的临床价值。方法 10 0例患者分成两组 ,PCS组(5 6例 )经药盒导管系统灌注抗癌药与碘油混合成的乳剂 ,TACE组 (44例 )按常规方法栓塞治疗 ,对每组患者的疗效及药物代谢特征分别进行观察。结果 PCS组患者肿瘤内的阿霉素可维持相当持久的较高浓度 ,7周后平均值 7.9ug/克并取得较好治疗效果 ,其 1、3年生存率分别为 36 /5 6 (6 4% )及 13/5 6 (2 3 % )。TACE组结果则较差 ,其阿霉素值为 4.4ug/克 ,1、3年生存率分别为 19/44 (43 % )及 5 /44 (11% )。结论 经PCS给药方法简便 ,疗效确切 ,经药物监测符合药代动力学规律 。

Objective To investgate the clinical value of chemoembolization via port catheter system versus routine chemoembolization on patients with liver cancer.Methods 100 patients with liver cancer were divided into two groups,treated by hepatic arteries infusion of the mixture of anticancer durgs with lipioldol via port catheter system(PCS group,n=56),or transarterial chemoembolization(TACE group,n=44),respectively.The pharmocokinetics and biodistribution of doxorubicin were studied by measuring doxorubicin level in cancer tissue after the administration.Results In PCS group the mixture of doxorubicin with lipiodol prolonged the release of the doxorubicin and remained in tumors for a long time,the mean level was 7.9ug/g after 7 weeks.Therefore better therapeutic effects were acheived,the survival rate for 1 year and 3 year was 36/56(64%) and 13/56(23%),respectively.The results of the patients in TACE group were different from the PCS group.The doxorubicin mean level was 4.4ug/gram after 7 weeks.The survival rate for 1 year and 3 year was 19/44(43%) and 5/44(11%),respectively(P<0.01).Conclusions Hepatic artery infusion of anticancer drugs via port catheter system is safe and effective method for treating primary hepatic carcinoma.