应用三氧化二砷连续区域化疗治疗肝癌

Continuous regional chemotherapy using arsenic trioxide for primary hepatic carcinoma

目的 研究三氧化二砷 (As2 O3 )对于原发性肝癌的化疗价值及其最佳给药方法。方法 对 17例不适合手术治疗的肝癌病人做经股或腋动脉穿刺 ,肝动脉造影 (DSA)后明确肿瘤的位置和范围 ,分别在肝左、肝右、肝固有动脉留置皮下埋藏式灌注装置 (微泵 ) ,然后将微泵与微量注射泵连接 ,给予As2 O3 连续区域化疗 (2 0mg/d ,连续 5d)。结果 给予 4个疗程 ,6例肿瘤体积缩小 5 0 %以上 ,无新病灶出现 (PR =35 2 % ) ;8例缩小 10 %～ 4 9% (显效率 4 1 1% ) ,1例无变化 ,2例肿瘤体积增大 2 5 %以上。 15例食欲改善 ,10例体重增加。 7例AFP下降或降至正常。 14例伴有肝区疼痛或不适减轻或消失。 10例发热 (37 5℃～ 38 4℃ ) ,停药后消失。结论 应用As2 O3 连续区域化疗对PHC具有一定治疗价值 ,具有毒副反应低 ,疗效确切的优点。

ObjectiveTo investigate the effect and best administration method of arsenic trioxide in chemotherapy for primary hepatic carcinoma (PHC). MethodsSeventeen patients with PHC underwent hepatic artery DSA. An implantable injecting catheter and port system were embedded in left, right or proper hepatic artery of each patient according to the position of the tumor. Arsenic trioxide was continuously infused at dosage of 20 mg/day for at least 3 hours each day through the catheter and port system for 5 days per course. Each course was 30 days. ResultsAfter the treatment for 4 courses (4 months), the tumor size decreased for over 50% in 6 patients (35.2%) without new tumors being detected and 10-49% in 8 (41.1%) without new tumors being detected. The tumor size remained unchanged in 1 patient and increased for over 25% in the left 2. Food appetite was improved in 15 patients and body weight increased in 10. AFP value decreased in 7 patients and pain in hepatic area disappeared in 14. Furthermore, fever occurred in 10 patients (37.5-38.4℃) and it disappeared after each course. ConclusionsArsenic trioxide is an efficient chemical with low toxicity and the best method for its administration is continuous regional infusion through the hepatic artery.