Misawa K, Une Y, Kamiyama T, Nakajima Y, Sato N, Matsushita M, Shimamura T, Masuko Y, Yasuhara M, Uchino J
First Dept. of Surgery, Hokkaido University School of Medicine.
Gan To Kagaku Ryoho. 1993 Aug;20(11):1477-80.
We studied the effect of adjuvant hepatic arterial chemotherapy with THP-adriamycin (THP) and carboplatin (CBDCA) in patients with hepatocellular carcinoma (HCC). Fifteen patients were treated by intraarterial infusion of THP 30 mg on the second and third week after hepatectomy. CBDCA 450 mg was further injected on the fourth week (group A). Intrahepatic arterial administration of the drug was carried out through the subcutaneously implanted reservoir; one to five courses of the protocol were performed (average 2 times). Transient leukocytopenia occurred in six cases, liver dysfunction in one case, duodenal ulcer in one case and occlusion of the catheter connected reservoir in three cases. Forty-two patients not treated with this protocol postoperatively were employed as historical control (group B). There were no significant differences between group A and B in operative procedures, tumor stage, clinical stage, tumor size and other histopathological findings including nuclear DNA ploidy pattern. The two-year cumulative disease-free survival rate was 78% in group A, which was significantly better than the 55% of group B (p < 0.05). It may be concluded that intrahepatic arterial chemotherapy using THP and CBDCA plays an important role to prevent recurrences of the tumor after hepatectomy in patients with HCC.
我们研究了肝动脉化疗辅助使用吡柔比星（THP）和卡铂（CBDCA）对肝细胞癌（HCC）患者的疗效。15例患者在肝切除术后第二周和第三周通过肝动脉内输注30mg THP进行治疗。在第四周进一步注射450mg CBDCA（A组）。通过皮下植入的储液器进行肝动脉内给药；进行1至5个疗程的方案（平均2次）。6例出现短暂性白细胞减少，1例出现肝功能障碍，1例出现十二指肠溃疡，3例出现连接储液器的导管堵塞。42例术后未采用该方案治疗的患者作为历史对照（B组）。A组和B组在手术操作、肿瘤分期、临床分期、肿瘤大小和其他组织病理学发现（包括核DNA倍体模式）方面无显著差异。A组的两年累积无病生存率为78%，显著高于B组的55%（p<0.05）。可以得出结论，使用THP和CBDCA进行肝动脉内化疗对预防HCC患者肝切除术后肿瘤复发起着重要作用。
