全反式维甲酸联合他莫昔芬及维生素E治疗晚期肝细胞癌
Treatment with all-trans retinoic acid plus tamoxifen and vitamin E in advanced hepatocellular carcinoma.
作者信息
Clerici Carlo, Castellani Danilo, Russo Giuseppe, Fiorucci Stefano, Sabatino Giuseppe, Giuliano Vittorio, Gentili Giorgio, Morelli Olivia, Raffo Patrizia, Baldoni Monia, Morelli Antonio, Toma Salvatore
机构信息
Clinic of Gastroenterology and Hepatology, University of Perugia, Italy.
出版信息
Anticancer Res. 2004 Mar-Apr;24(2C):1255-60.
BACKGROUND
Low serum retinol and hepatic tocopherol levels correlate with hepatocellular carcinoma (HCC) risk. Antiestrogen tamoxifen seems useful in HCC patients. A pilot study was performed to evaluate the effect of all-trans retinoic acid associated with tamoxifen and vitamin E on patients with advanced HCC.
PATIENTS AND METHODS
Fifteen consecutive patients with advanced HCC were included in the study. Patients were evaluated for survival, quality of life, liver function, tumor mass, toxicity related to the treatment and retinoid receptors in liver biopsies.
RESULTS
The median survival of our patients was 22 months. Pain and asthenia were improved in the majority of patients. Every patient with baseline elevated liver enzymes showed an improvement in liver function. RAR-alpha, RXR-alpha, RAR-beta and RAR-gamma receptors were demonstrated in 100%, 73%, 47% and 40%, respectively.
CONCLUSION
A combination therapy of all-trans retinoic acid, tamoxifen and vitamin E increases the survival rate and ameliorates the clinical outcome in patients with inoperable HCC.
背景
血清视黄醇水平低和肝脏维生素E水平低与肝细胞癌（HCC）风险相关。抗雌激素他莫昔芬似乎对HCC患者有用。进行了一项前瞻性研究，以评估全反式维甲酸联合他莫昔芬和维生素E对晚期HCC患者的疗效。
患者和方法
15例连续的晚期HCC患者纳入本研究。对患者进行生存、生活质量、肝功能、肿瘤大小、治疗相关毒性以及肝活检中类视黄醇受体的评估。
结果
我们患者的中位生存期为22个月。大多数患者的疼痛和乏力得到改善。每位基线肝酶升高的患者肝功能均有改善。RAR-α、RXR-α、RAR-β和RAR-γ受体的表达率分别为100%、73%、47%和40%。
结论
全反式维甲酸、他莫昔芬和维生素E联合治疗可提高无法手术切除的HCC患者的生存率并改善临床结局。
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