Kawai S, Tani M, Mikuriya S, Inoue J, Shimamura Y, Takahashi A, Masuzawa M, Jinno K, Makino M, Oda T
Dept. of Surgery, National Medical Center Hospital.
Gan To Kagaku Ryoho. 1990 Feb;17(2):227-32.
A cooperative group study was carried out on the effect of Lipiodol transcatheter arterial chemo-embolization (L-TACE) for non-resectable hepatocellular carcinoma (HCC). Thirty-seven hospitals in Japan participated in this study and a total of 157 eligible patients included 138 males and 19 females with an average age of 60.3 y.o. In the chemo-embolization, Lipiodol mixed with 20-50 mg/m2 of doxorubicin (adriamycin) was given through a catheter, and this was followed by embolization with gelatin sponge. Effect of additional oral 5-FU (150-200 mg/day) was also studied as an open trial. Levels of serum alpha-feto protein decreased at 10 days after L-TACE, and this decrease lasted for 5 weeks. CR was observed in one patient, PR in 33, MR in 24, NC in 66 and PD in 16. The response rate was 24.3%. Cumulative one-year, two-year and three-year survival rates were 56.0%, 30.8% and 26.4%, respectively. It was concluded that higher survival rates after L-TACE were observed when (1) patients had better functional reserves of the liver, (2) HCC was in the less advanced stage and (3) L-TACE was carried out more than twice. A reduction of the tumor size after L-TACE did not necessarily mean a good prognosis for the patients. There was no significant difference in the survival rate between the patients taking or not taking 5-FU.
开展了一项关于碘油经导管动脉化疗栓塞术（L-TACE）治疗不可切除肝细胞癌（HCC）效果的合作组研究。日本37家医院参与了本研究，共有157例符合条件的患者，其中男性138例，女性19例，平均年龄60.3岁。在化疗栓塞术中，通过导管注入与20 - 50 mg/m²阿霉素（多柔比星）混合的碘油，随后用明胶海绵进行栓塞。还作为开放试验研究了额外口服5-氟尿嘧啶（150 - 200 mg/天）的效果。L-TACE术后10天血清甲胎蛋白水平下降，且这种下降持续5周。观察到1例患者完全缓解（CR），33例部分缓解（PR），24例疾病稳定（MR），66例疾病无变化（NC），16例疾病进展（PD）。缓解率为24.3%。1年、2年和3年累积生存率分别为56.0%、30.8%和26.4%。得出的结论是，当（1）患者肝脏功能储备较好，（2）HCC处于较早期阶段，（3）L-TACE进行超过两次时，L-TACE术后生存率较高。L-TACE术后肿瘤大小的缩小不一定意味着患者预后良好。服用或未服用5-氟尿嘧啶的患者生存率无显著差异。
