原发性肝细胞癌术后预防性肝动脉灌注化疗的临床研究

Clinical research on prophylactic hepatic artery infusion chemotherapy after curative resection in patients with primary hepatocellular carcinoma

目的探讨预防性肝动脉灌注化疗(HAIC)对原发性肝细胞癌(HCC)患者术后生存率的影响。方法回顾性地分析85例HCC患者的临床资料,其中术后行预防性HAIC 42例(HAIC组)和未行HAIC 43例(对照组),两组性别、年龄、肿瘤部位、肝功能分级、AFP水平、肿瘤大小和TNM分期等差异无统计学意义(P>0.05)。HAIC组术后3周予肝动脉灌注化疗(5-FU 1 000 mg/m2、奥沙利铂85 mg/m2和吉西他滨1 000 mg/m2)。观察比较两组肝内复发发生率、无病生存率、总生存率及安全性。结果 HAIC组和对照组3年无肝内复发生存率、无瘤生存率、总生存率分别为80.95%vs 60.47%,66.67%vs 44.19%,66.67%vs 46.51%;差异均有统计学意义(P<0.05)。HAIC组患者均能耐受化疗,无Ⅲ度以上毒性发生。结论对HCC患者术后肝动脉灌注化疗可显著降低术后肝内复发率,延长患者生存期,且安全性好。

Objective To explore the survival probability of prophylactic hepatic artery infusion chemotherapy（HAIC） after curative resection in patients with primary hepatocellular carcinoma（HCC）. Methods We retrospectively analyzed the clinicd data of 85 cases with HCC assigned to HAIC group（42 cases） and control group（43 cases）. HAIC groups underwent hepatic artery infusion chemotherapy（5-FU 1 000 mg/m^2, Oxaliplatin85 mg/m^2 and Gemcitabine 1 000 mg/m^2） 3 weeks after operation. All cases were followed up for 3 years and intrahepatic recurrence-free survival, disease-free survival rate and overall survival rate were recorded. Results Liver-metastasis free survival rate of HAIC group and the control group was respectively 80.95% and 60.47%（P〈0.05）. Disease-free survival rate was respectively 66.67% and 44.19%（P〈0.05）. Overall survival rate was66.67% and 46.51%（P〈0.05）. HAIC group tolerated the therapy and no adverse effect above grade 3 was reported. Conclusion HAIC effectively and safely prevents intrahepatic recurrence and improves the prognosis of patients with HCC after curative resection.