Oyamada H, Yoshikawa T, Itani K, Ichikawa H, Tainaka K, Seto O, Sugino S, Kondo M
First Dept. of Internal Medicine, Kyoto Prefectural University of Medicine.
Gan To Kagaku Ryoho. 1989 Aug;16(8 Pt 2):3070-4.
Antitumor effects and prognosis of the patients with unresectable hepatocellular carcinoma were investigated in the treatment of chemo-embolization using degradable starch microspheres (DSM) and regional hyperthermia. Twenty-six cases were treated with chemo-embolization using DSM alone (Group A) and eighteen cases were treated with combination of chemo-embolization and hyperthermia (Group B). Tumor regression rates over 50% were 42% (11/26) and 56% (10/18) in Group A and Group B, respectively. In the patients with tumors over 7 cm in diameter, no favorable response was obtained in Group A (0/11), but the response rate was increased to 56% (5/9) by the combination of hyperthermia. In the patients with arterio-portal shunt, therapeutic effects were observed in 17% (1/6) and 50% (1/2) of Group A and Group B, respectively. In the patients with portal invasion (Vp2 and Vp3), no favorable response was demonstrated in Group A (0/4), but tumor response was demonstrated in one out of 3 cases in Group B. One- and two-year survival rates were 59% and 53%, respectively, in Group A, and 93% and 45%, respectively, in Group B. The DSM, temporary embolus, is suitable for the combination of hyperthermia because chemo-embolization using DSM can be performed many times. Therefore, these results suggested that chemo-embolization using DSM should be beneficial as combination therapy for unresectable hepatocellular carcinoma.
采用可降解淀粉微球（DSM）和区域热疗进行化疗栓塞治疗，研究不可切除肝细胞癌患者的抗肿瘤效果及预后。26例患者单纯采用DSM化疗栓塞治疗（A组），18例患者采用化疗栓塞与热疗联合治疗（B组）。A组和B组肿瘤缩小率超过50%的分别为42%（11/26）和56%（10/18）。直径大于7 cm的肿瘤患者，A组未获得良好反应（0/11），但热疗联合后反应率提高到56%（5/9）。有动静脉分流的患者，A组和B组的治疗有效率分别为17%（1/6）和50%（1/2）。有门静脉侵犯（Vp2和Vp3）的患者，A组未显示良好反应（0/4），但B组3例中有1例显示肿瘤反应。A组1年和2年生存率分别为59%和53%，B组分别为93%和45%。DSM作为临时栓塞剂适合与热疗联合，因为使用DSM的化疗栓塞可多次进行。因此，这些结果提示，使用DSM的化疗栓塞作为不可切除肝细胞癌的联合治疗可能有益。
