亚砷酸联合干扰素治疗中晚期原发性肝癌的临床研究

Arsenic trioxide combined with INF-α in the treatment of advanced primary liver cancer

目的 :评价亚砷酸注射液 (三氧化二砷 )联合α 干扰素治疗中晚期原发性肝癌的疗效及不良反应。方法 :中晚期肝癌患者 2 2例 ,其中男性 18例 ,女性 4例 ;肝细胞癌 19例 ,胆管细胞癌 3例 ;Ⅱ期 4例 ,Ⅲ期 18例。将亚砷酸注射液 10mg加入 5 %葡萄糖注射液 5 0 0ml中 ,缓慢静滴 3小时以上 ,每日 1次 ;α 干扰素 30 0万U ,皮下注射 ,每日 1次。以上药物连用 2 8天为一周期 ,间歇 2周重复 ,连用 2个周期为一疗程。结果 :全组有效率为 13 6 % (3/ 2 2 ) ,其中部分缓解 3例 ,稳定 15例 ,恶化4例。所有患者治疗后均有不同程度的全身症状改善 ,通常用药一周后普遍肝区疼痛减轻。治疗后卡氏评分平均上升 2 0分。从治疗首日开始算起 ,半年生存率为 72 7% (16 / 2 2 ) ,1年生存率为 5 4 5 % (12 / 2 2 )。不良反应主要为轻度的骨髓抑制、药物热和腹胀 ,少数患者出现轻度乏力、口干、恶心呕吐和肝功能异常。结论 :亚砷酸注射液联合α 干扰素治疗中晚期原发性肝癌疗效较好 ,不良反应可以耐受 ,值得进一步研究。

Objective:To evaluate the therapeutic effect and side effect of arsenic trioxide combined with INF α in the treatment of advanced primary liver cancer.Methods:Twenty two cases with advanced hepatic carcinomas involving eighteen males and four females; nineteen cases with hepatocellular carcinoma and three with cholangiocellular carcinoma, four cases of stage Ⅱ and eighteen of stage Ⅲ. Treatment with 10mg arsenic trioxide dissolved in 5% glucose injected intravenously over above 3 hours and with INF α 3000000 U injected subcutaneously was used daily for 28 days and repeated after 2 weeks.Results:The total response rate was 13 6%(3/22) in which 3 PR and 15 NC, PD 4 cases. All patients had improvement of symptoms, 6 months survival rate was 72 7%(16/22), 12 months survival rate was 54 5%(12/22). Side effects of slight myeolosupression, fever and tympanites, infrequent side effect were debility, thirsty, nausea, vomiting and turbulence of liver function.Conclusion:Arsenic trioxide combined with INF α reveals effective in the treatment of advanced primary liver cancers and its side effect seems supportable. The modality is worth studying in the further.