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目的探讨三氧化二砷(As2O3)注射液单药连续区域动脉灌注化疗原发性肝癌的临床疗效。方法55例手术不能切除的非晚期原发性肝癌患者,随机分为两组:(1)As2O3治疗组26例:患者采用经股动脉肝动脉碘油栓塞后埋置皮下化疗泵,予以连续区域灌注As2O3化疗,20mg/d,每天1次,共7d,间隔4周重复,共5疗程。(2)对照组29例:采用经股动脉肝动脉栓塞化疗(TACE),2次TACE15例,3次TACE14例。结果As2O3治疗组总有效率为34.6%(9/26)、肿瘤复发率为15.4%(4/26)、1年生存率为80.7%(21/26);TACE组分别是31.0%(9/29)、37.9%(11/29)、51.7%(15/29)。统计学分析表明,两组的总有效率差异无统计学意义,P>0.05;肿瘤复发率和1年生存率差异有统计学意义,P<0.05。As2O3治疗组较对照组不良反应轻微,未见不可逆不良反应。结论经股动脉肝动脉碘油栓塞后埋置皮下化疗泵予以连续区域灌注As2O3化疗用于治疗原发性肝癌不良反应轻微、疗效确切,具有一定的临床应用前景。
Objective To investigate the clinical efficacy of continuous arsenic trioxide (As2O3) injection in the treatment of primary hepatocellular carcinoma with continuous regional arterial infusion. Methods 55 patients with unresectable non-advanced primary liver cancer were randomly divided into two groups: (1) As2O3 treatment group (n = 26): patients underwent subcutaneous chemo pump embolization with hepatic artery lipiodol, Perfusion As2O3 chemotherapy, 20mg / d, 1 day, a total of 7d, repeat 4 weeks, a total of 5 courses. (2) In the control group, 29 cases were treated with transcatheter hepatic arterial chemoembolization (TACE), 2 times TACE in 15 cases and 3 times TACE in 14 cases. Results The total effective rate of As2O3 group was 34.6% (9/26), the recurrence rate was 15.4% (4/26), the 1-year survival rate was 80.7% (21/26) 29), 37.9% (11/29), 51.7% (15/29). Statistical analysis showed that the total effective rate was no significant difference between the two groups, P> 0.05; the tumor recurrence rate and 1-year survival rate difference was statistically significant, P <0.05. As2O3 treatment group than the control group minor adverse reactions, no irreversible adverse reactions. Conclusions The subcutaneous chemotherapy pump embolized with hepatic artery lipiodol in the femoral artery can be used to continuously treat As2O3 chemotherapy for the treatment of primary liver cancer with mild side effect and definite curative effect. It has certain clinical application prospect.