Nakamura H, Hashimoto T, Taguchi T, Oi H, Inoue K, Seki K, Mizumoto S, Tsukaguchi I, Araki Y, Sawada S
Gan To Kagaku Ryoho. 1987 Feb;14(2):381-7.
Since 1983 we have performed transcatheter oily chemoembolization (TOCE) using adriamycin (40-100 mg), Lipiodol (5-20 ml) and Gelfoam in the treatment of 100 cases with unresectable hepatocellular carcinoma. Adriamycin was dissolved in a fluid equal in specific gravity to Lipiodol and the adriamycin solution was mixed with 3 volumes of Lipiodol, making an adriamycin-in-oil emulsion (AOE). After TOCE, the blood concentration of adriamycin was obviously lower than that after one-shot injection because of the slow release of adriamycin from the AOE. Also, in cases of hepatic resection after TOCE, there was a clear difference in the adriamycin concentration between the tumor and the normal hepatic tissue. The cumulative survival rates for the 100 patients treated by TOCE were: 6 months 81.9%, 1 year 53.8% and 2 years 36.5%. Thus, improvement was found in comparison with the cumulative survival rates for 104 patients who underwent hepatic embolization without Lipiodol, which were 6 months 67.4%, 1 year 45.2% and 2 years 16.3%. AOE retained in the tumor as microemboli brings about the slow-releasing effect of adriamycin. Furthermore, by adding the effect of Gelfoam embolization, TOCE has a strong antitumor effect.
自1983年以来，我们使用阿霉素（40 - 100毫克）、碘油（5 - 20毫升）和明胶海绵进行经导管油性化疗栓塞术（TOCE），治疗了100例无法切除的肝细胞癌患者。阿霉素溶解在与碘油比重相同的液体中，阿霉素溶液与3倍体积的碘油混合，制成阿霉素油乳剂（AOE）。TOCE后，由于阿霉素从AOE中缓慢释放，阿霉素的血药浓度明显低于单次注射后。此外，在TOCE后进行肝切除的病例中，肿瘤组织和正常肝组织中的阿霉素浓度存在明显差异。接受TOCE治疗的100例患者的累积生存率为：6个月81.9%，1年53.8%，2年36.5%。因此，与104例未使用碘油进行肝栓塞的患者的累积生存率相比有所提高，后者分别为6个月67.4%，1年45.2%，2年16.3%。作为微栓塞保留在肿瘤中的AOE产生阿霉素的缓释作用。此外，通过增加明胶海绵栓塞的作用，TOCE具有很强的抗肿瘤作用。
