[1]高 嵩,朱旭,杨仁杰,等. ＴＡＣＥ联合奥沙利铂、氟尿嘧啶、亚叶酸钙肝动脉化疗治疗中晚期原发性肝癌[J].介入放射学杂志,2012,(05):377-383.
　,,et al. ＴＡＣＥ ｃｏｍｂｉｎｅｄ ｗｉｔｈ ｈｅｐａｔｉｃ ａｒｔｅｒｉａｌ ｉｎｆｕｓｉｏｎ ｃｈｅｍｏｔｈｅｒａｐｙ ｕｓｉｎｇ ｏｘａｌｉｐｌａｔｉｎ， ５ｆｌｕｏｒｏｕｒａｃｉｌ ａｎｄ ｆｏｌｉｎｉｃ ａｃｉｄ ｆｏｒ ｉｎｔｅｒｍｅｄｉａｔｅ ａｎｄ ａｄｖａｎｃｅｄ ｈｅｐａｔｏｃｅｌｌｕｌａｒ ｃａｒｃｉｎｏｍａｓ[J].journal interventional radiology,2012,(05):377-383.
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 ＴＡＣＥ联合奥沙利铂、氟尿嘧啶、亚叶酸钙肝动脉化疗治疗中晚期原发性肝癌 ()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2012年05期
页码:
377-383
栏目:
肿瘤介入
出版日期:
2012-05-30

文章信息/Info

Title:
 ＴＡＣＥ ｃｏｍｂｉｎｅｄ ｗｉｔｈ ｈｅｐａｔｉｃ ａｒｔｅｒｉａｌ ｉｎｆｕｓｉｏｎ ｃｈｅｍｏｔｈｅｒａｐｙ ｕｓｉｎｇ ｏｘａｌｉｐｌａｔｉｎ， ５ｆｌｕｏｒｏｕｒａｃｉｌ ａｎｄ ｆｏｌｉｎｉｃ ａｃｉｄ ｆｏｒ ｉｎｔｅｒｍｅｄｉａｔｅ ａｎｄ ａｄｖａｎｃｅｄ ｈｅｐａｔｏｃｅｌｌｕｌａｒ ｃａｒｃｉｎｏｍａｓ
作者:
 高 嵩;  朱旭; 杨仁杰; 郭建海
Author(s):
 ＧＡＯ Ｓｏｎｇ;  ＺＨＵ Ｘｕ;  ＹＡＮＧ Ｒｅｎｊｉｅ;  ＧＵＯ Ｊｉａｎｈａｉ．
 Ｋｅｙ Ｌａｂｏｒａｔｏｒｙ ｏｆ Ｃａｒｃｉｎｏｇｅｎｅｓｉｓ ａｎｄ Ｔｒａｎｓｌａｔｉｏｎａｌ Ｒｅｓｅａｒｃｈ （Ｍｉｎｉｓｔｒｙ ｏｆ Ｅｄｕｃａｔｉｏｎ）， Ｉｎｔｅｒｖｅｎｔｉｏｎａｌ Ｔｈｅｒａｐｙ Ｄｅｐａｒｔｍｅｎｔ， Ｐｅｋｉｎｇ Ｕｎｉｖｅｒｓｉｔｙ Ｃａｎｃｅｒ Ｈｏｓｐｉｔａｌ ＆ Ｉｎｓｔｉｔｕｔｅ， Ｂｅｉｊｉｎｇ １００１４２， Ｃｈｉｎａ
关键词:
 ; 【关键词】 原发性肝癌;  化疗栓塞;  奥沙利铂;  氟尿嘧啶;  亚叶酸钙;  肝动脉化疗
文献标志码:
A
摘要:
 【摘要】 目的 评价肝动脉化疗栓塞术（ＴＡＣＥ）联合奥沙利铂（ＯＸＡ）／氟尿嘧啶（５Ｆｕ）／亚叶酸钙（ＣＦ）方案肝动脉化疗治疗中晚期原发性肝癌（ＨＣＣ）的可行性、疗效和安全性。方法 ２００８ 年７ 月至２０１０ 年１２ 月，经组织病理活检诊断或临床诊断为不可切除且无远处转移的ＨＣＣ ５０ 例患者入组，ＴＡＣＥ术后经留置导管实施肝动脉灌注化疗（ＨＡＩＣ），方案：ＯＸＡ ６０　～　７５　ｍｇ／ｍ２，第０　～　４小时泵入；ＣＦ ２００ ｍｇ／ｍ２，第４　～　６小时泵入；５Ｆｕ １ ～　１．５　ｇ／ｍ２，第６　～　２４小时泵入。每４　～　６周一疗程，直至疗效评价ＣＲ（ｍＲＥＣＩＳＴ １．１标准）或出现肝功能ＣｈｉｌｄＰｕｇｈ Ｃ级、远处转移及不可耐受的不良反应。术后观察患者不良反应，定期复查实验室指标及增强ＣＴ或ＭＲＩ评估疗效，定期随访。结果　　　全部５０ 例患者共进行２３２次ＴＡＣＥ联合ＯＸＡ、５Ｆｕ、ＣＦ方案ＨＡＩＣ治疗。疗效评价：ＣＲ１０例；ＰＲ ２１例；ＳＤ ６例；ＰＤ １３例；客观有效率（ＯＲＲ ）为７４％；疾病控制率（ＤＣＲ）为６２％。患者中位随访时间为１７．１个月（２．６　～　３７．１个月），中位疾病无进展生存（ＰＦＳ）为９．３个月，中位总生存时间（ＯＳ）为２１．４个月，累计１年、２年生存率为７６％、４４％。用Ｌｏｇｒａｎｋ检验行单因素分析：肝功能ＣｈｉｌｄＰｕｇｈ Ａ 级（Ｐ　＝　０．００６）、无肿瘤血管侵犯（Ｐ　＝　０．００３）、总胆红素值 ＜　３４．２　μｍｏｌ／Ｌ（Ｐ　＝　０．０２３）的患者预后好于对照组。Ｃｏｘ模型多因素分析：肿瘤血管侵犯（Ｐ　＝　０．０４５）是患者独立预后不良因素。患者Ⅲ　～　Ⅳ度不良反应少见，仅有２例发生Ⅲ度神经毒性，无留置导管相关并发症。结论 ＴＡＣＥ联合ＯＸＡ／５－Ｆｕ／ＣＦ方案ＨＡＩＣ治疗无远处转移且不可切除的ＨＣＣ，疗效肯定，安全性好。

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