温热介入与常规介入治疗肝癌毒副反应比较

Comparison of Toxicities of Transcatheter Arterial Chemoembolization with and without Hyperthermia for Hepatocellular Carcinoma

[目的]探讨动脉温热灌注对肝癌化疗栓塞毒副反应的影响。[方法]肝癌86例,分别采用温热介入治疗(治疗组,35例)和常规介入治疗(对照组,51例)。治疗组中化疗药和碘油均加温至62℃行化疗栓塞治疗。对照组行常规化疗栓塞治疗。[结果]两组的主要毒副反应均有右上腹部疼痛(分别为60%和54.9%)、发热(均为100%)、乏力(均为100%)和恶心呕吐(分别为25.7%和19.6%);不同程度的白细胞、血小板减少等血液毒性和谷丙转氨酶升高等肝脏毒性。两组比较差异无统计学意义(P>0.05)。[结论]温热与化疗栓塞适当结合,既可进一步提高肝癌疗效,对其毒副反应又无显著影响。

To investigate the toxicities of interventional treatment with and without hyperthermia for hepatocelluar carcinoma(HCC).Eighty-six patients with HCC were classified into two groups randomly:treatment group(n=35)and control group(n=51).The treatment group was treated with transhepatic arterial thermochemotherapy and embolization.The chemotherapeutic agents and lipiodol were warmed to62℃before use.The control group was treated with routine interventional therapy.Main toxicities in treatment and control groups were pain in the right upper quadrant(60%vs54.9%),fever(all in both),lethargy(all in both),nausea and vomiting(25.7%vs19.6%).Hepatic and hematologic toxicities extent including ALT change,leukopenia,thrombocytopenia were damaged in certain degree,but no significant difference in both groups(P>0.05).[Conclusion]Hyperthermia can improve the therapeutic effect of the transcatheter arterial chemoembolization without increasing its toxicities.