经皮植入药盒系统肝动脉持续灌注氟尿嘧啶脱氧核苷治疗晚期原发性肝癌

Continuous Hepatic Arterial Infusion Chemotherapy with Floxuridine via Port-catheter System in the Treatment of Advanced Primary Hepatocellular Carcinoma

目的探讨经皮植入药盒系统肝动脉持续灌注氟尿嘧啶脱氧核苷(FUDR)治疗晚期原发性肝癌的临床疗效和安全性。方法 56例无外科手术指征的晚期原发性肝癌患者分为观察组及对照组。观察组28例采取经左锁骨下动脉植入药盒肝动脉内灌注FUDR 0.4 mg·m-2·d-1,持续14 d,每21 d重复1次;对照组进行最佳支持治疗,比较2组的甲胎蛋白(AFP)变化、生活质量及生存时间。结果观察组AFP下降超过20%者占32.1%,KPS评分改善者占42.9%,中位生存期6.5个月,与对照组的3.6%、10.7%及3.8个月比较差异有统计学意义(P<0.05)。观察组治疗的毒副反应可以耐受。结论经皮植入药盒系统肝动脉持续灌注FUDR可改善患者的生活质量,延长生存时间,是治疗晚期原发性肝癌的有效方法之一。

Objective To investigate the clinical efficacy and toxicities of continuous hepatic arterial infusion chemotherapy with floxuridine via port-catheter system in the treatment of advanced primary hepatocellular carcino-ma. Methods Fifty-six patients with advanced primary hepatocellular carcinoma were divided into the observation group and the control group. The 28 patients in the observation group received continuous hepatic arterial infusion chemotherapy with FUDR（0. 4 mg·m-2 ·d-1 for 14 days,a cycle of 21 days）via port-catheter system;the 28 patients in the control group received the best supportive care. The changes of alpha-fetoprotein（ AFP）,quality of life,survival time were observed. Results Among 28 patients in the observation group,9 patients（ 32. 1%） showed more than a 20% decrease in their serum AFP levels from baseline,the KPS score improving rates was 42. 9%,and the median overall survival time was 6. 5 months;and were 3. 6%,10. 7% and 3. 8 months in the con-trol group（P 〈0. 05）. The toxicities could be tolerated. Conclusion The continuous hepatic arterial infusion chemotherapy with FUDR via port-catheter system is safe and effective in the treatment of advanced primary hepato-cellular carcinoma.