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目的观察三氧化二砷(As2O3)-碘化油乳剂经肝动脉化疗栓塞(TACE)治疗原发性肝细胞癌(PHC)的临床疗效。方法PHC患者145例,根据碘化油所用乳化药物不同分为三组:As2O3+碘化油组(A组)47例、阿霉素+碘化油组(B组)48例和单纯碘化油组(C组)50例。首次TACE治疗后4~6周再行第2次TACE治疗。随访1年以上,观察临床疗效及不良反应。结果A、B、C组的近期临床有效率分别为59.6%、41.7%、40.0%,疾病控制率分别为93.6%、79.2%、72.0%,中位生存期分别为30、26、25个月。A组近期临床有效率、疾病控制率及中位生存期均优于B、C组(P<0.05)。三组TACE术后主要不良反应为恶心、呕吐、肝区疼痛、发热、骨髓抑制及肝功能受损等,经对症处理后均缓解或消失。结论 As2O3-碘化油乳剂TACE治疗PHC的临床疗效确切,不良反应可耐受。
Objective To observe the clinical efficacy of arsenic trioxide (As2O3) -iodinated oil emulsion in the treatment of primary hepatocellular carcinoma (PHC) by transcatheter arterial chemoembolization (TACE). Methods 145 cases of PHC patients were divided into three groups according to the different emulsified drugs used in iodized oil: 47 cases in As2O3 + iodized oil group (group A), 48 cases in adriamycin + iodized oil group (group B) and pure iodized oil Group (C group) 50 cases. The first TACE treatment 4 to 6 weeks after the second TACE treatment. Follow-up more than 1 year, observe the clinical efficacy and adverse reactions. Results The short-term clinical efficacy rates of group A, B and C were 59.6%, 41.7% and 40.0% respectively, and the disease control rates were 93.6%, 79.2% and 72.0% respectively. The median survival time was 30, 26 and 25 months . The recent clinical efficiency, disease control rate and median survival in group A were better than those in group B and C (P <0.05). Three major adverse reactions after TACE were nausea, vomiting, liver pain, fever, myelosuppression and impaired liver function. All patients were relieved or disappeared after symptomatic treatment. Conclusion As2O3-iodized oil emulsion TACE treatment of PHC clinical curative effect, adverse reactions can be tolerated.