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顺铂与α干扰素联合治疗晚期肝细胞癌

Combined cis-platinum and alpha interferon therapy of advanced hepatocellular carcinoma.

作者信息

Ji S K, Park N H, Choi H M, Kim Y W, Lee S H, Lee K H, Ahn S Y, Lee S U, Han B H, Park B C

机构信息

Department of Internal Medicine, Kosin Medical College, Pusan, Korea.

出版信息

Korean J Intern Med. 1996 Jan;11(1):58-68. doi: 10.3904/kjim.1996.11.1.58.

Abstract

To evaluate the clinical efficacy of alpha-interferon(IFN-alpha) plus cis-platinum in hepatocellular carcinoma(HCC). 56 inoperable patients with HCC were divided into IFN-alpha plus cis-platinum treated group (n = 30) and no antitumor therapy group (n = 26). The survival of IFN-alpha plus cis-platinum treated patients was significantly better than that of patients who received no antitumor therapy (p = 0.001). Median survival time was 33 weeks and 14.0 weeks, respectively. The cumulative estimated survival rates of our IFN-alpha plus cis-platinum treated group (93.5% at 3mo, 75.0% at 6mo) were for longer than that of the no antitumor therapy group (84.6% at 3mo, 57.7% at 6mo). Objective tumor regression, greater than 50% was observed in 13.3% (4 of 30) of patients receiving IFN-alpha plus cis-platinum. By the univariate analysis, the absence of portal vein thrombus (p < 0.05), alkaline phosphatase lesser than 280 U/L (p = 0.001), total bilirubin less than 2.0 mg% (p < 0.05), serum triglyceride less than 155 mg/dl (p < 0.05) were shown to be the factors most significantly favoring a better survival. By the multivariate analysis, using Cox proportional hazards model, IFN-alpha plus cis-platinum treated group (p = 0.0001), alkaline phosphatase less than 280 mg/dl (p = 0.005), the absence of portal vein thrombus (p = 0.020) were independent favorable prognostic factors. We conclude that IFN-alpha plus cis-platinum is useful in patients with inoperable HCC and the above favorable prognostic factors may also be useful in the design and analysis of future clinical trials of systemic chemotherapy for HCC.

摘要

为评估α-干扰素(IFN-α)联合顺铂治疗肝细胞癌(HCC)的临床疗效。将56例无法手术的HCC患者分为IFN-α联合顺铂治疗组(n = 30)和未进行抗肿瘤治疗组(n = 26)。IFN-α联合顺铂治疗患者的生存期明显优于未进行抗肿瘤治疗的患者(p = 0.001)。中位生存时间分别为33周和14.0周。我们的IFN-α联合顺铂治疗组的累积估计生存率(3个月时为93.5%,6个月时为75.0%)长于未进行抗肿瘤治疗组(3个月时为84.6%,6个月时为57.7%)。接受IFN-α联合顺铂治疗的患者中,13.3%(30例中的4例)出现了大于50%的客观肿瘤退缩。单因素分析显示,无门静脉血栓(p < 0.05)、碱性磷酸酶低于280 U/L(p = 0.001)、总胆红素低于2.0 mg%(p < 0.05)、血清甘油三酯低于155 mg/dl(p < 0.05)是最显著有利于更好生存的因素。多因素分析使用Cox比例风险模型显示,IFN-α联合顺铂治疗组(p = 0.0001)、碱性磷酸酶低于280 mg/dl(p = 0.005)、无门静脉血栓(p = 0.020)是独立的有利预后因素。我们得出结论,IFN-α联合顺铂对无法手术的HCC患者有用,上述有利预后因素也可能有助于未来HCC全身化疗临床试验的设计和分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9804/4532007/0ecf9de08364/kjim-11-1-58-7f1.jpg

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