Ando E, Yamashita F, Tanaka M, Tanikawa K
Second Department of Medicine, Kurume University School of Medicine, Fukuoka-ken, Japan.
Cancer. 1997 May 15;79(10):1890-6. doi: 10.1002/(sici)1097-0142(19970515)79:10<1890::aid-cncr8>3.0.co;2-k.
Hepatocellular carcinoma (HCC) with tumor thrombosis of the main trunk of the portal vein (PVTT) has a poor prognosis. This study was designed to evaluate the efficacy of arterial infusion chemotherapy for advanced HCC of this type.
Nine patients with HCC were treated by arterial infusion of a chemotherapeutic agent via a subcutaneously implanted injection port. One course consisted of the daily administration of cisplatin (10 mg for 1 hour on Days 1-5) and the subsequent infusion of 5-fluorouracil (250 mg for 5 hours on Days 1-5). In principle, patients were to receive four serial courses of chemotherapy.
The mean course of chemotherapy was 4.6 (range, 2.6-7.6) months. The serum total concentrations of alpha-fetoprotein and des-gamma-carboxyprothrombin were reduced after chemotherapy in most of the patients. Two patients showed complete response (CR) with disappearance of HCC and PVTT after treatment, and the other two showed partial response (PR) (response rate [CR + PR/All cases], 44.4%). The 3-year survival rate was 40%. The mean survival after the therapy was 14.9 (range, 4.1-48.9) months. The 50% survival was 9.2 months. Adverse reactions were tolerable nausea and loss of appetite.
This chemotherapeutic regimen achieved favorable results and may be useful in treating patients with HCC with tumor thrombosis of the main trunk of the portal vein.
伴有门静脉主干肿瘤血栓形成（PVTT）的肝细胞癌（HCC）预后较差。本研究旨在评估动脉灌注化疗对这类晚期HCC的疗效。
9例HCC患者通过皮下植入的注射端口进行动脉灌注化疗药物。一个疗程包括每日给予顺铂（第1 - 5天，10 mg，持续1小时），随后输注5-氟尿嘧啶（第1 - 5天，250 mg，持续5小时）。原则上，患者要接受四个连续疗程的化疗。
化疗的平均疗程为4.6（范围2.6 - 7.6）个月。大多数患者化疗后血清甲胎蛋白和异常凝血酶原的总浓度降低。2例患者治疗后显示完全缓解（CR），HCC和PVTT消失，另外2例显示部分缓解（PR）（缓解率[CR + PR/所有病例]，44.4%）。3年生存率为40%。治疗后的平均生存期为14.9（范围4.1 - 48.9）个月。50%的生存期为9.2个月。不良反应为可耐受的恶心和食欲减退。
这种化疗方案取得了良好的效果，可能对治疗伴有门静脉主干肿瘤血栓形成的HCC患者有用。
