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目的评价持续榄香烯乳经皮左锁骨下动脉植入药盒导管系统(PCDDS)灌注化疗转移性肝癌的临床疗效。方法1997～2006年,31例晚期转移性肝癌患者接受了持续榄香烯乳联合化疗药物动脉经PCDDS灌注化疗。PCDDS介入化疗方案:阿霉素40mg/m2(第1天),顺铂40mg/m2(第1天),5-氟尿嘧啶1.0g/m2(第2～3天持续48h动脉泵入),灌注5-氟尿嘧啶使用亚叶酸钙0.3g经外周静脉2h滴入。榄香烯乳300mg每日经PCDDS灌注治疗,连续20d为1个周期,每4～6周重复1次。化疗2个周期后评价近期临床疗效、不良反应和生活质量,如有效继续治疗至疾病进展。结果31例患者共进行了185个周期PCDDS灌注化疗,平均6.5个周期(2～10个)。其中2例CR(6.6%),20例PR(64.5%),总有效率为71.0%。生存期3.52～43.20个月,中位生存期17.6个月,中位疾病无进展时间(PFS)为11.3个月,1、2年生存率分别为65.23%和32.65%。主要不良反应包括3～4度消化道反应(9.7%,3/31),3～4度中性粒细胞减少症(12.9%,4/31),3～4度肝功能损害(9.7%,3/31),1例患者出现了导管漏液而拔管。23例(74.2%)患者KSP评分得到提高。结论持续榄香烯乳联合化疗药物经PCDDS灌注治疗转移性肝癌安全有效,耐受性好。
Objective To evaluate the clinical efficacy of continuous infusion of elemene percutaneous transcatheter arterial catheterization (PCDDS) in the treatment of metastatic liver cancer. Methods From 1997 to 2006, 31 patients with advanced metastatic HCC underwent continuous infusion of elemene combined with chemotherapy drug through PCDDS. PCDDS intervention chemotherapy: doxorubicin 40mg / m2 on day 1, cisplatin 40mg / m2 on day 1, 5-fluorouracil 1.0g / m2 on day 2 to 3 for 48h, - Fluorouracil Leucovorin 0.3g by the peripheral intravenous infusion 2h. Elemene 300mg daily perfusion by PCDDS treatment, a continuous 20d cycle, every 4 to 6 weeks to repeat 1 times. After 2 cycles of chemotherapy to evaluate the recent clinical efficacy, adverse reactions and quality of life, such as the effective continuation of treatment to disease progression. Results A total of 185 cycles of PCDDS perfusion chemotherapy were performed in 31 patients, with an average of 6.5 cycles (2 to 10). Two cases of CR (6.6%), 20 cases of PR (64.5%), the total effective rate was 71.0%. Survival ranged from 3.52 to 43.20 months. The median survival time was 17.6 months. The median progression-free time (PFS) was 11.3 months. The 1-year and 2-year survival rates were 65.23% and 32.65%, respectively. The main adverse reactions included 3-4 degrees of gastrointestinal reaction (9.7%, 3/31), 3-4 degrees of neutropenia (12.9%, 4/31), 3-4 degrees of hepatic impairment (9.7%, 3 / 31). One patient had catheter leakage and extubation. KSP scores were improved in 23 patients (74.2%). Conclusions Continuous elemene combined with chemotherapeutic drugs is safe and effective in treating metastatic liver cancer by PCDDS perfusion.