肝动脉灌注LAK/IL-2及化疗药物治疗晚期肝癌

Infusing LAK/IL-2 and chemotherapy drugs into hepatic artery to treat late stage liver cnacer

目的观察经皮肝动脉插管化疗药物灌注、栓塞术联合LAK／IL－2灌注治疗中晚期肝癌的疗效、T淋巴细胞改变及副反应。方法96例经确诊的今晚期肝癌，随机分为动脉化疗栓塞联合LAK/IL－2观察组及单纯介入化疗栓塞组各48例。两组均采用经皮穿刺肝动脉插管灌注化疗药物及栓塞。化疗药物5-Fu1000mg＋卡铂300mg＋表阿霉素30mg或丝裂霉素10～20mg，栓塞剂为碘化油和明胶海绵，介入治疗3～4周1次，2次1疗程。观察组检室后沿导管灌注同种异体LAK细胞1×109/100ml及IL－240万U，两次介入间隔期观察组每周3次静滴1×109／100mlLAK细胞及每日从注IL－210万U。结果观察组总有效率（CR＋PR）为72．9％（35／48），对照组总有效率（CR＋PR）为58．3％（28／48），两组比较有显著性差异（P＜0．05）。观察组T淋巴细胞治疗前后变化有统计学意义（P＜0．01），而对照组无统计学意义。结论同种异体LAK细胞联合化疗及栓塞治疗中晚期肝癌较单纯介入化疗栓塞疗效明显提高，是安全可行的一种治疗方法。

Objective To observe the therapeutic effectiveness,the change of T lymphocytes and the side effects of percutaneous cannula of hepatic artery to infuse chemotherapy drugs,embolize combined with LAK/IL-2 in the treatment of medium and late stage liver cancer. Methods: 96 cases of medium and late stage liver cancer comfirmed diagnosis were randomly allocated into the observing group (composed of interventional chemotherapy, embolism combined with LAK/IL-2)and simple interventional chemotherapy as well as embolism group,48 cases in each group. The two groups were both given percutaneous puncture of liver artery,then infusing of chemotherapy drugs and embolism, Chemotherapy drugs comprised 5-Fu 1000mg, Carboplatin 300mg and Rubinmycin 30mg or Mytomycin 10~20mg,and suppositories was iodized oil and gel foam. Intervetional chemotherapy was given once every 3~4 weeks, 2times in on therapeutic course. The observing group was infused homologuous LAK cells 1×109/100ml and IL-2 400×1oooU in the interventional chemotherapy. During the intermission the observing group was given LAK cells 1×109/100ml three times in onc week and IL-2 100,000 u. q. d. Results:The effective rate (CR+PR) of the observing group was 72. 9% (35/48),and it was 58. 3% (28/48) in the control group. The differecne was significant (P <0. 05). The change of T lymphocytes had statistical value (P <0. 01),but the other group had no value.Conclusion: Homologuous LAK cells combined with chemothcrapy and embolism in treating medium and late stage liver cancer had higher therapeutic effectiveness than simple chemotherapy and embolism. So it is a kind of safe treatment.