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[碘油混悬顺铂经动脉化疗栓塞术治疗不可切除肝细胞癌的疗效与毒性]

[Efficacy and toxicity of transcatheter arterial chemoembolization with Cisplatin suspended in lipiodol for unresectable hepatocellular carcinoma].

作者信息

Uyama Naoki, Hatano Etsuro, Maetani Yoji, Isoda Hiroyoshi, Shibata Toshiya, Taura Kojiro, Oe Shoshiro, Naito Masato, Yasuchika Kentaro, Fujii Hideaki, Ikai Iwao, Uemoto Shinji

机构信息

Dept. of Gastroenterological Surgery, Kyoto University Graduate School of Medicine.

出版信息

Gan To Kagaku Ryoho. 2008 May;35(5):775-80.

Abstract

In this study we evaluated the efficacy and toxicity of transcatheter arterial chemoembolization (TACE) with Cisplatin (CDDP)-Lipiodol (LIP) suspension in 24 patients with advanced hepatocellular carcinoma (HCC). Eligibility criteria were as follows; unresectable HCC, age <75 years, performance status (PS) 0-2, Child-Pugh A or B and adequate heart and renal function. When TACE was performed, the catheter was placed selectively in feeding arteries of the tumors, and CDDP-LIP suspension (20 mg/mL) was injected followed by gelatin sponge particles. The direct and total effect on tumors were evaluated 3 and 6 months after TACE, respectively. As for a direct effect, complete and partial response rates were 54.2% and 25%, respectively. As for a total effect, complete and partial response rates were 41.7% and 4.1%, respectively. Grade 3/4 drug-related toxicities were as follows: thrombocytopenia (13%), appetite loss (8%) and nausea (4%). These severe side effects disappeared within 10 days after TACE. No renal and hepatic dysfunction was encountered, and no drug-related deaths occurred. TACE with CDDP suspended in LIP may provide some clinical benefits with relatively tolerable toxicities.

摘要

在本研究中,我们评估了顺铂(CDDP)-碘油(LIP)混悬液经动脉化疗栓塞术(TACE)治疗24例晚期肝细胞癌(HCC)患者的疗效和毒性。入选标准如下:不可切除的HCC、年龄<75岁、体能状态(PS)0-2、Child-Pugh A或B级且心肾功能良好。进行TACE时,将导管选择性地置于肿瘤供血动脉中,注入CDDP-LIP混悬液(20mg/mL),随后注入明胶海绵颗粒。分别在TACE术后3个月和6个月评估对肿瘤的直接和总体疗效。就直接疗效而言,完全缓解率和部分缓解率分别为54.2%和25%。就总体疗效而言,完全缓解率和部分缓解率分别为41.7%和4.1%。3/4级药物相关毒性如下:血小板减少(13%)、食欲减退(8%)和恶心(4%)。这些严重副作用在TACE术后10天内消失。未出现肾肝功能障碍,也未发生药物相关死亡。CDDP混悬于LIP中的TACE可能具有一定临床益处且毒性相对可耐受。

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