Li Jing-Huan, Xie Xiao-Ying, Zhang Lan, Le Fan, Ge Ning-Ling, Li Li-Xin, Gan Yu-Hong, Chen Yi, Zhang Ju-Bo, Xue Tong-Chun, Chen Rong-Xin, Xia Jing-Lin, Zhang Bo-Heng, Ye Sheng-Long, Wang Yan-Hong, Ren Zheng-Gang
Jing-Huan Li, Xiao-Ying Xie, Lan Zhang, Fan Le, Ning-Ling Ge, Li-Xin Li, Yu-Hong Gan, Yi Chen, Ju-Bo Zhang, Tong-Chun Xue, Rong-Xin Chen, Jing-Lin Xia, Bo-Heng Zhang, Sheng-Long Ye, Yan-Hong Wang, Zheng-Gang Ren, Key Laboratory of Carcinogenesis and Cancer Invasion, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Ministry of Education, Shanghai 200032, China.
World J Gastroenterol. 2015 Apr 7;21(13):3970-7. doi: 10.3748/wjg.v21.i13.3970.
To investigate transarterial chemoembolization (TACE) with hepatic infusion of oxaliplatin and 5-fluorouracil and Lipiodol chemoembolization in large hepatocellular carcinoma (HCC).
In this retrospective study, 132 patients with unresectable HCCs larger than 10 cm were treated with hepatic infusion of oxaliplatin and 5-fluorouracil followed by Lipiodol chemoembolization. The primary endpoint was overall survival (OS). Sixteen-week disease-control rate, time to progression (TTP), and major complications were also studied. Univariate and multivariate analyses were performed to identify prognostic factors affecting OS and TTP.
A total of 319 procedures were performed in the 132 patients. Eleven (8.3%) patients received radical resection following TACE treatment (median time to initial TACE 4.3 ± 2.3 mo). The median OS and TTP were 10.3 and 3.0 mo respectively, with a 50.0% 16-wk disease-control rate. Major complications were encountered in 6.0% (8/132) of patients following TACE and included serious jaundice in 1.5% (2/132) patients, aleukia in 1.5% (2/132), and hepatic failure in 3.0% (4/132). One patient died within one month due to serious hepatic failure and severe sepsis after receiving the second TACE. The risk factor associated with TTP was baseline alpha-fetoprotein level, and vascular invasion was an independent factor related to OS.
Hepatic infusion of oxaliplatin and 5-fluorouracil followed by lipiodolized-chemoembolization is a safe and promising treatment for patients with HCCs larger than 10 cm in diameter.
探讨经动脉化疗栓塞术（TACE）联合肝内输注奥沙利铂和5-氟尿嘧啶以及碘油化疗栓塞术治疗大肝癌（HCC）的效果。
在这项回顾性研究中，132例无法切除且肿瘤直径大于10 cm的肝癌患者接受了肝内输注奥沙利铂和5-氟尿嘧啶，随后进行碘油化疗栓塞术。主要终点是总生存期（OS）。还研究了16周疾病控制率、疾病进展时间（TTP）和主要并发症。进行单因素和多因素分析以确定影响OS和TTP的预后因素。
132例患者共进行了319次手术。11例（8.3%）患者在TACE治疗后接受了根治性切除术（首次TACE的中位时间为4.3±2.3个月）。中位OS和TTP分别为10.3个月和3.0个月，16周疾病控制率为50.0%。6.0%（8/132）的患者在TACE后出现主要并发症，包括1.5%（2/132）的患者出现严重黄疸、1.5%（2/132）的患者出现白细胞减少、3.0%（4/132）的患者出现肝衰竭。1例患者在接受第二次TACE后因严重肝衰竭和严重脓毒症在1个月内死亡。与TTP相关的危险因素是基线甲胎蛋白水平，血管侵犯是与OS相关的独立因素。
肝内输注奥沙利铂和5-氟尿嘧啶后行碘油化疗栓塞术是治疗直径大于10 cm的肝癌患者的一种安全且有前景的治疗方法。
