摘要
目的探讨吉西他滨、奥沙利铂(GEMOX)方案肝动脉化疗栓塞(TACE)联合三维适形放疗(3-DCRT)治疗晚期原发性肝癌的疗效和不良反应。方法经病理或影像学明确诊断的70例晚期原发性肝癌患者,采用GEMOX方案:吉西他滨0.8～1.0 g/m2,奥沙利铂85～100 mg/m2加入超液化碘油10～30 ml行TACE治疗,每月1次,连用2～3次。经TACE治疗后3～4周行3-DCRT:总剂量(DT)48～60Gy,每次4～5 Gy,隔天1次,每周3次,连续4周。结果 2例患者3-DCRT后4个月内死亡,未能评价疗效,其余68例原发性肝癌患者中完全缓解(CR)4.4%(3/68),部分缓解(PR)70.6%(48/68),稳定(SD)14.7%(10/68),进展(PD)10.3%(7/68);总有效率(CR+PR)75.0%(51/68),肿瘤控制率(CR+PR+SD)为89.7%(61/68)。总生存中位数10个月(8.4～11.6),无瘤生存时间中位数6.0个月(4.6～7.4),1、2、3年生存率分别为58.8%,29.4%和19.1%。常见的不良反应主要表现为白细胞减少、贫血、血小板减少、恶心、呕吐和发热等,患者均可耐受。结论 GEMOX方案TACE联合3-DCRT治疗晚期原发性肝癌疗效确切,不良反应可耐受,值得进一步研究。
Objective To investigate the clinical effects and untoward reactions of transcatheter arterial chemoembolization （TACE） with regimen GEMOX together with three- dimensional conformal radiotherapy （3-DCRT） for the treatment of advanced inoperable primary hepatoceUular carcinoma （HCC）. Methods A total of 70 patients with pathologically or imaging confirmed advanced inoperable primary HCC were enrolled in this study. TACE with GEMOX regimen （gemcitabine 0.8 - 1.0 g/m2, oxaliplatin 85 - 100 mg/ m2 plus super-liquefactive iodized oil） was carried out once a month in all patients for 2 - 3 successive months. Three to four weeks after TACE, 3-DCRT was conducted with a total dose of 48 - 64 Gy （4 - 5 Gy per fraction at an interval of 48 hours）, and 3 fractions were given every week. The clinical results were analyzed. Results Two patients died four months after 3-DCRT was completed. The clinical effects of the remaining 68 patients were evaluated. Of the 68 patients, complete remission （CR） was obtained in 3 （4.4%）, partial remission （PR） in 48 （70.6%）, stable disease （SD） in 10 （14.7%）, and progress disease （PD） in 7 （10.3%）. The total effective rate （CR ＋ PR） was 75.0% （51/68）. The tumor control rate （CR ＋ PR ＋ SD） was 89.7% （61/68）. The survival time varied from 8.4 to 11.6 months with a median time of 10.0months. The median PFS was 6.0 months （95% CI： 4.6 - 7.4 months）. The overall survival rates at 1, 2 and 3 years were 58.8%, 29.4% and 19.1%, respectively. The common untoward reactions includedleucopenia, anemia, thrombocytopenia, nausea, vomiting and fever, which could be tolerated by the patients. Conchmion TACE with GEMOX regimen combined with 3-DCRT has definite therapeutic effect on inoperable primary hepatocellular carcinoma, and its untoward reactions can be tolerated by the patients. It is of value to make a further study on this technique.
出处
《介入放射学杂志》
CSCD
北大核心
2013年第4期292-296,共5页
Journal of Interventional Radiology
基金
重庆市医学重点研究室建设项目资助(2007-14)
关键词
原发性肝癌
动脉化疗栓塞
三维适形放疗
奥沙利铂
吉西他滨
transcatheter arterial chemoembolization
three- dimensional conformal radiotherapy
oxaliplatin
gemeitabine
primary hepatoeellular carcinoma
