褪黑素联合肝动脉栓塞化学药物治疗中晚期肝癌

Treatment of advanced primary liver cancer by melatonin and transcatheter arterial chemoembolization

目的 比较中晚期原发性肝癌患者单纯行肝动脉化学药物栓塞 (TACE)及加用褪黑素(MLT)的临床效果。方法 1997年 1月至 1998年 1月收治 10 0例不能 1期手术的中晚期肝癌病人 ,TACE治疗组 5 0例 ;MLT +TACE组 5 0例 ,在TACE治疗前 1周起开始口服MLT 2 0mg/d。结果 两组近期有效率 (WHO标准 )分别为 16% ( 8/5 0 )和 2 8% ( 14 /5 0 ) (P <0 0 5 ) ,0 5年、1年及 2年生存率TACE组分别为 82 % ( 4 1/5 0 )、5 4 % ( 2 7/5 0 )和 2 6% ( 13 /5 0 ) ,MLT +TACE组分别为 10 0 % ( 5 0 /5 0 )、68% ( 3 4 /5 0 )及 4 0 % ( 2 0 /5 0 ) ,两组比较MLT +TACE组疗效明显优于单纯TACE组 (P均 <0 0 5 )。MLT可使TACE治疗后患者外周血IL 2的含量提高及SIL 2R的表达降低 (P <0 0 1)。结论 MLT可增强患者的免疫保护 ,提高TACE的疗效 ,延长患者的生存期。

Objective To compare the clinical efficacy of transcatheter arterial chemoembolization (TACE) alone and TACE+MLT(Melatonin) for patients with unresectable advanced primary liver cancer(PLC). Method From Jan. 1997 to Jan. 1998, 100 admitted patients with unresectable PLC were randomized into 50 cases receiving TACE alone and 50 cases treated by TACE+MLT (20 mg/day × 7 days before TACE). ResultsThe effective rate(WHO standard) of TACE and TACE+MLT were 16% and 28% respectively( P <0 05). The 0 5, 1, and 2 year′s survival rate in TACE group was 82%,54% and 26% respectively, and in TACE+MLT group was 100%,68% and 40% respectively(all P <0 05).IL 2 levels significantly increased while sIL 2R expression decreased in MLT+TACE group ( P <0 01). Conclusion MLT significantly enhanced the immunological protection of PLC patients, improved the effect of TACE, and prolonged survival.