肝动脉化疗栓塞术联合氟尿嘧啶缓释剂序贯治疗中晚期肝癌

Transarterial chemoembolization in combination of consecutive sustained-release 5-fluorouracil in the treatment of mid-late stage liver cancer

目的观察肝动脉化疗栓塞术(TACE)联合氟尿嘧啶缓释剂序贯治疗中晚期肝癌的临床疗效。方法 TACE后肿瘤灶碘油沉积缺损型和稀少型的中晚期肝癌患者65例,其中33例给予氟尿嘧啶缓释剂注入治疗(治疗组),32例仅行TACE治疗(对照组),比较两组患者术后肝功能、近期临床效果。结果两组患者术后肝功能Child-Pugh评分均逐渐增加,但治疗组肝功能Child-Pugh评分低于对照组(P<0.05);术后6个月,对照组部分缓解2例,病情稳定16例,病情进展14例,总体有效率为6.25%(2/32),治疗组分别为8例、20例、5例、24.2%(8/33),治疗组近期疗效优于对照组(P<0.05)。治疗组术后中位生存时间为24.92个月,对照组为16.87个月;治疗组术后2年累积生存率为49.0%,对照组为14.0%。结论TACE联合氟尿嘧啶缓释剂序贯治疗可提高碘油沉积缺损型和稀少型的中晚期肝癌近期疗效,改善患者预后,是一种安全有效的姑息性治疗方法。

Objective To observe the clinical effects of transarterial chemoembolization（ TACE） in combination of consecutive sustained-release 5-fluorouracil in treating mid-late stage liver cancer. Methods Of 65 patients of mid-late stage liver cancer with poor iodipin deposit after TACE,33（ treatment group） were consecutively prescribed with slow-released 5-fluorouracil injection in lesion,and the other 32（ control group） received no consecutive treatment. Liver function and short-term clinical effects of the two groups were comparatively analyzed. Results After treatment,Child-Pugh score of postoperative liver function gradually increased in both two groups,but the score was lower in the treatment group than in the control（ P 〈0. 05）. Six months after operation,number of patients in partial remission,unchanged,or progress condition were 8,20,5,respectively,with a total effective rate of 24. 2%（ 8 /33） in the treatment group,better than the corresponding2,16,14,and 6. 25%（ 2 /32） in the control group（ P 〈0. 05）. The median survival time of treatment and control group after operation was24. 92 months,16. 87 months,and 2-year survival rates were 49. 0%,14. 0%,respectively. Conclusion For mid-late stage liver cancer with poor iodipin deposit,TACE combined with consecutive slow-released 5-fluorouracil is a safe and effective protocol,for it can improve the therapeutic effect and prognosis.