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目的:评价亚砷酸-碘油乳剂栓塞治疗原发性肝癌(HCC)的疗效与不良反应。方法:应用亚砷酸-碘油乳剂(亚砷酸注射液20mg与碘油5·0~30mL)经肝动脉栓塞治疗经病理、AFP和影像学诊断证实的HCC29例,如果治疗中病变明显进展(病灶增大超过25%或AFP升高),则联合蒽环类药物治疗,观察其疗效与不良反应。结果:单纯应用亚砷酸-碘油乳剂治疗1~3次,29例中PR6例,NC18例,PD5例,客观有效率为20·7%,获益率为82·8%;AFP平均由(11109·36±2920·82)IU/mL降至(10001·61±2880·67)IU/mL,t=1·262,P>0·05。11例患者在治疗中加用蒽环类药物,8例病灶中6例缩小超过25%,其中2例超过50%,AFP平均由(13901·11±4862·26)IU/mL降至(5470·63±2597·79)IU/mL(t=2·634,P<0·05)。主要不良反应为发热、恶心呕吐、肝区疼痛、血细胞减少及转氨酶升高等,全组未发生严重不良反应。结论:亚砷酸-碘油乳剂栓塞治疗原发性肝疗效较好,不良反应较小,是治疗原发性肝癌较理想的方法之一。
Objective: To evaluate the efficacy and adverse reactions of arsenite-lipiodol embolization in the treatment of primary liver cancer (HCC). Methods: Twenty-nine cases of HCC confirmed by pathology, AFP and imaging diagnosis were treated with arsenite-lipiodol emulsion (arsenic acid injection 20 mg and lipiodol 5.0 to 30 mL). (increased lesions more than 25% or elevated AFP), combined anthracycline treatment, observed its efficacy and adverse reactions. Results: The arsenite-lipiodol emulsion was used to treat 1~3 times. In 29 cases, 6 cases were PR, 6 cases were NC, and 5 cases were PD. The objective and effective rate was 20.7%, and the benefit rate was 82.8%; the average AFP was (11109·36±2920·82) IU/mL decreased to (10001·61±2880·67) IU/mL, t=1·262, P>0.05 and 11 patients were treated with anthracycline Drugs, 8 cases of lesions in 6 cases shrink more than 25%, of which 2 cases exceed 50%, AFP average from (13901 · 11 ± 4862 · 26) IU/mL to (5470 · 63 ± 2597 · 79) IU/mL ( t=2·634, P<0·05). The main adverse reactions were fever, nausea, vomiting, liver pain, hematopoiesis, and elevated transaminases. No serious adverse reactions occurred in the whole group. Conclusion: The efficacy of arsenite-lipiodol emulsion embolization for treating primary liver is good, and the adverse reaction is small. It is an ideal method for the treatment of primary liver cancer.