Nakashima K, Aramaki M, Yoshida T, Kim Y I, Kitano S, Kobayashi M, Suzuki K, Aikawa H
First Dept. of Surgery, Oita Medical University.
Gan To Kagaku Ryoho. 1993 Aug;20(11):1481-4.
Eighty surgically treated patients with advanced hepatocellular carcinoma (HCC) were divided into two groups. In group I, twenty patients whose mean diameter of tumors was 56 mm, prophylactically underwent hepatic arterial infusion chemotherapy after liver resection. Chemotherapeutic agents (5-FU, ADM, MMC, CDDP, Lipiodol) were administered 4 times a year via Infuse A port. The remaining 60 patients, whose mean diameter of tumors was 57 mm, served as the control without prophylactic infusion (group II). The 2-year cumulative survival rate was higher in the prophylactic group (71%) than the control (48%, p = 0.040). The two-year disease-free survival rate was improved in group I (38%) compared with that in group II (27%, p = 0.021). Intrahepatic multiple recurrence within 1 year after surgery was recognized in four out of 18 patients of group I (22%) and in thirty-three out of 60 patients of group II (55%, p = 0.029). In group I, two cases who died of hepatic failure with no recurrence, had lower functional reverse and a larger amount of Lipiodol than the remaining 18 patients. Adjuvant arterial infusion chemotherapy can thus be be efficacious in alleviating hepatoma recurrence after liver resection. For patients with poor liver function, a smaller volume of chemotherapeutic agents might be feasible.
80例接受手术治疗的晚期肝细胞癌（HCC）患者被分为两组。在第一组中，20例肿瘤平均直径为56mm的患者在肝切除术后预防性地接受了肝动脉灌注化疗。化疗药物（5-氟尿嘧啶、阿霉素、丝裂霉素、顺铂、碘油）每年通过输液港给药4次。其余60例肿瘤平均直径为57mm的患者作为未进行预防性灌注的对照组（第二组）。预防性治疗组的2年累积生存率（71%）高于对照组（48%，p = 0.040）。与第二组（27%，p = 0.021）相比，第一组的2年无病生存率有所提高。第一组18例患者中有4例（22%）在术后1年内出现肝内多发复发，第二组60例患者中有33例（55%，p = 0.029）出现肝内多发复发。在第一组中，2例死于肝功能衰竭且无复发的患者，其肝功能恢复较差，碘油用量比其余18例患者多。因此，辅助性动脉灌注化疗在减轻肝切除术后肝癌复发方面可能有效。对于肝功能较差的患者，较小剂量的化疗药物可能是可行的。
