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[肝硬化肝细胞癌化疗评估]

[Evaluation of chemotherapy in hepatocellular carcinoma with liver cirrhosis].

作者信息

Munehisa T, Tajima H, Goto M, Nakata K, Muro T, Kawahara K, Kohno K, Sato A, Furukawa R, Ogino T

出版信息

Gan To Kagaku Ryoho. 1983 Nov;10(11):2318-23.

PMID:6314913
Abstract

The present paper discusses the efficacy of cancer chemotherapy in 46 patients with advanced hepatocellular carcinoma. In most of patients, Adriamycin (20-40 mg) or Mitomycin C (20 mg) was given by one shot injection via the hepatic artery and followed by serial administration of anticancer agents such as 5-fluorouracil (300-750 mg/day), Adriamycin and Toyomycin. Results were as follows: 1) The complete response was not seen. 2) The partial response (more than 50% decrease of the tumor size) was observed in 6 of 46 patients (13%) for 34 to 457 days. 3) Absence of tumor thrombi in the portal vein which was observed by hepatic angiography, CT and ultrasonography, was closely correlated in the partial response and the prolongation of survival time. 4) There were no significant differences with the therapeutic response or survival time among 3 groups (E2: tumor occupation rate (TOR) 20-40%, E3: TOR 40-60%, E4: TOR above 60%). 5) Obstinate abdominal pain and abnormal liver function remarkably were improved during the chemotherapy in 11 of 18 cases (61%), and 6 of 46 cases (13 %), respectively. 6) Major causes of death were hepatic failure (45.7%), gastrointestinal bleeding (30.4%) and intra-abdominal rupture of the tumor (14.7%). 7) As side effect, some extent of hematopoietic suppression was observed in 25% of the patients treated.

摘要

本文探讨了癌症化疗对46例晚期肝细胞癌患者的疗效。大多数患者通过肝动脉一次性注射阿霉素(20 - 40毫克)或丝裂霉素C(20毫克),随后连续给予抗癌药物,如5 - 氟尿嘧啶(300 - 750毫克/天)、阿霉素和东洋霉素。结果如下:1)未观察到完全缓解。2)46例患者中有6例(13%)出现部分缓解(肿瘤大小减少超过50%),持续34至457天。3)通过肝血管造影、CT和超声检查观察到门静脉无肿瘤血栓,这与部分缓解和生存时间的延长密切相关。4)3组(E2:肿瘤占有率(TOR)20 - 40%,E3:TOR 40 - 60%,E4:TOR高于60%)在治疗反应或生存时间方面无显著差异。5)18例中有11例(61%)、46例中有6例(13%)在化疗期间顽固性腹痛和肝功能异常分别得到明显改善。6)主要死亡原因是肝衰竭(45.7%)、胃肠道出血(30.4%)和肿瘤腹腔内破裂(14.7%)。7)作为副作用,在接受治疗的患者中有25%观察到一定程度的造血抑制。

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