三氧化二砷-碘化油乳剂经动脉栓塞治疗原发性肝细胞癌的临床疗效

摘要

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、阿霉素十碘化油组(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 A2O3-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 transarterial chemoembolization (TACE) with arsenic trioxide (As2O3)-lipiodol emulsion in treating the patients with primary hepatocellular carcinoma(PHC).Methods A total of 145 PHC patients was randomly divided into three groups of A(treated with As2 O3 + lipiodol,47 cases),B(treated with doxorubicin+ lipiodol,48 cases) and C(treated with lipiodol alone,50 cases).The second treatment of TACE was performed after 4-6 weeks of the first TACE treatment.The patients were followed up for over one year.Clinical efficacy and adverse effects were compared among three groups.Results The short-term clinical response rate,disease control rate and median survival period in group A were 59.6％,93.6％ and 30 months,respectively,which were better than those in groups of B(41.7 ％,79.2 ％ and 26 months) and C(40.0％,72.0％ and 25 months) (P＜0.05).The major adverse dfects of three groups were nausea,vomiting,hepatalgia,fever,myelosuppression and liver dysfunction,which were attenuated or disappeared after symptomatic treatments.Conclusion For treating the patients with PHC,TACE with As2C3-lipiodol emulsion is definitely effective with tolerable adverse effects.