雷替曲塞介入治疗不可切除原发性肝癌的疗效及安全性分析

The Effect and Safety of Raltitrexed Combinated Oxaliplatin/Pirarubicin in Interventional Treatment of Advanced Unresectable Primary Liver Cancer

[目的]探讨应用雷替曲塞介入治疗不可切除原发性肝癌的疗效及安全性。[方法]35例不可手术切除的原发性肝癌患者采用雷替曲塞/奥沙利铂/吡柔比星方案行肝动脉化疗栓塞术,记录观察术中、术后不良反应,术后3-6周复查血常规、肝脏功能、肿瘤指标AFP及影像学检查（DSA造影、CT、MRI）进行疗效及安全性评估。[结果]35例患者完全缓解1例（2.8%）、部分缓解23例（65.7%）、稳定8例（22.8%）和进展5例（14.2%）,有效率为68.5%;甲胎蛋白下降〉50%20例（57.1%）。中位随访时间为281d,中位无进展生存时间为101.5d（95%CI：87.8-146.2）。主要不良反应均为Ⅰ-Ⅱ级,无Ⅳ级不良反应。[结论 ]含雷替曲塞方案经动脉化疗栓塞治疗不可切除原发性肝癌的疗效确切,不良反应轻,值得临床推广应用。

[Objective] To observe the effect and safety of unresectable primary liver cancer by transcatheter hepatic arterial chemoembolization（TACE） with raltitrexed treatment. [Metheods ]Transcatheter hepatic arterial chemoembolization combinated with lobaplatin/floxuridine/pirarubicin were used to treat 35 unresectable primary liver cancer patients. The DSA/MRI/CT/blood routine examination were used to were evaluated the short term activity and toxicity after 4 -5 weeks,the process was repeated if necessary. [Results] Among the 35 cases,1 case（2.8%）showed a complete response,21 cases（65.7%） showed a partial response,8 cases（22.8%） showed stable diseaseand,and 5 cases（14.2%） showed progressive disease,with a total effective rate of68.5%. The content of AFP dropped by over 50% in 20（57.8%） cases.The median follow-up time（MFT）was 281 days（61-556 days）,the median progression-free survival was 101.5 days（95%CI：87.8-146.2）. Main reactions（Ⅰ-Ⅱ grade）were commom,reactions（Ⅲ-Ⅳ grade） were not observed. [Conclusion] Transcatheter hepatic arterial chemoembolization with ratitrexed treatment is an effective and safe treatment for primary liver cancer.