^(125)I-抗AFP抗体介入导向治疗肝癌的药物体内代谢和疗效观察

Metabolism and efficacy study of ^(125)I-anti-AFP administrated by interventional route for primary liver cancer

目的 :研究 1 2 5I 抗AFP抗体经肝动脉介入灌注后的体内代谢特点 ,并探讨导向综合治疗中晚期原发性肝癌的疗效。方法 :经肝动脉灌注 1 2 5I 抗AFP结合化疗栓塞 (TACE)和静脉滴注CD3 AK细胞综合治疗原发性肝癌患者 2 1例 ,检测 1 2 5I 抗AFP抗体在病人体内的药代动力学各项参数及体内生物学分布特点 ,并对比观察导向治疗组与对照组临床疗效。结果 :1 2 5I 抗AFP抗体血中放射性T1 2 α、T1 2 β分别为 1.85± 1.79及 15 6 .46± 6 5 .11小时 ,尿放射活性半排时间为 94小时 ,器官体表外辐射强度测定提示肝脏相对其他器官有强度较强及时间较长的放射性积蓄 ,肝脏SPECT检查瘤 肝比平均值为 2 .1± 0 .6 ,。导向组和对照组的有效率为 6 1.9%(13 2 1)与 2 5 .0 %(5 2 0 ) ,1年累计生存率比较亦为 6 1.9%与 2 5 .0 %,差异均有显著性 (P <0 .0 5 )。结论 :1 2 5I 抗AFP抗体经肝动脉给药后可选择性滞留在肝肿瘤内较长时间而起持续内照射作用 ,与TACE和免疫治疗应用是肝癌综合治疗的有效方案。

Purpose:To study the characteristics of biological distribution in vivo and therapeutic efficacy of 125 I-anti-alpha-fetoprotein(AFP) antibody when administrated by the hepatic artery , and discussion of multi-modal therapy by transcatheter arterial chemoembolization(TACE) and immunization therapy. Methods:21 patients with moderately and advanced primary liver cancer (PLC) were treated by 125 I-anti -alpha-fetoprotein which was administered via hepatic artery, together with TACE and CD3AK cell by intravenous infusion to,detect the pharmacokinetic parameters and metabolism for 125 I-anti-AFP in vivo, and observe the efficacy of multi-modal treatment. Results:The radioactivity half-life time of αphase (T 1/2 α) and β phase ( T 1/2 β) for 125 I-anti-AFP antibodies was 1.85±1.79 and 156.46±65 hr,respectively; half-excretion time from urine was 94 hr, radiation intensity measured at body surface of organ suggested that the accumulated radioactivity was stronger and longer in the liver was than other organ.TPECT for tumour:liver ratio was 2.1±0.6. The efficacy for the treated group and the control group was respectively 61.9%(13/21) and 25.0%(5/20),the one-year cumulative survival rate of the treated group and the control group was also 61.9% and 25.0%.Conclusions: 125 I-anti-AFP via hepatic artery was able to concentrate electively in the tumour ,thereby bringing about a continuous internal irradiation for the tumour.This combined treatment is an effective method for PLC.