奥沙利铂、丝裂霉素和多柔比星联合三维适形放疗用于乏血供肝癌的临床观察
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篇名: 奥沙利铂、丝裂霉素和多柔比星联合三维适形放疗用于乏血供肝癌的临床观察
TITLE:
摘要: 目的:观察奥沙利铂、丝裂霉素和多柔比星联合三维适形放疗用于乏血供肝癌的疗效和安全性。方法: 62例丧失手术机会的乏血供肝癌患者随机分为对照组(31例)和观察组(31例)。对照组患者采用Seldiner法经股动脉穿刺,选择性介入肝固有动脉行数字减影血管造影后,经导管注入注射用奥沙利铂130 mg/m2,静脉滴注,每 2 周1次+注射用丝裂霉素10 mg,静脉注射,每1~3周1次+注射用盐酸多柔比星1.2 mg/kg,每3周1次,后给予碘化油乳化剂及明胶海绵粒,每月1次,共3次后行肝动脉化疗栓塞术。观察组患者在对照组治疗的基础上给予三维适形放疗2 Gy,共25~30次,放射总剂量为50~60 Gy,每3日1次。两组均治疗3个月。观察两组患者的临床疗效,1、2、3年的生存率及中位生存时间,并记录不良反应发生情况。结果:观察组患者总有效率,1、2、3年生存率和中位生存时间均显著高于对照组,差异有统计学意义(P<0.05)。观察组患者粒细胞减少、血小板减少、血红蛋白下降、放射性疾病发生率均显著高于对照组,差异均有统计学意义(P<0.05)。结论:奥沙利铂、丝裂霉素和多柔比星联合三维适形放疗用于乏血供肝癌患者的疗效较好,可延长患者生存时间,但安全性较差。
ABSTRACT: OBJECTIVE: To observe the efficacy and safety of oxaliplatin, mitomycin and doxorubicin combined with three-dimensional conformal radiotherapy for patients with lack of blood supply hepatocellular carcinoma. METHODS:62 patients with lack of blood supply hepatocellular carcinoma who lose the opportunity of operation were randomly divided into control group (31 cases) and observation group (31 cases). Control group received puncture through the femoral artery by Seldiner, selectively intervening in hepatic arteries for DSA angiography, then intravenously injected 130 mg/m2 Oxaliplatin for injection via the catheter, once every 2 weeks+Mitomycin for injection 10 mg, intravenously, once every 1-3 week(s)+Doxorubicin for injection 1.2 mg/kg, once every 3 weeks, then giving Iodinated oil emulsifier and Gelatin sponge particle for hepatic artery embolization, appropriate Iodinated oil emulsifier and Gelatin sponge particle once a month, for 3 times. Observation group was additionally received three-dimensional conformal radiotherapy 2 Gy, for 25-30 times with total dose of 50-60 Gy, once every 3 days. They were treated for 3-month. Clinical efficacy, the survival rate and median survival time after the first administration of drug for 1, 2 and 3 years in 2 groups were observed, and the incidence of adverse reactions was recorded. RESULTS: The total effective rate, the survival rate and median survival time in 1, 2 and 3 years in observation were significantly higher than control group, with statistical significance (P<0.05). The incidences of neutropenia, thrombocytopenia, hemoglobin decreased and radioactive disease in observation group were significantly higher than control group, with statistical significances (P<0.05). CONCLUSIONS: Oxaliplatin, mitomycin and doxorubicin combined with three-dimensional conformal radiotherapy have good efficacy for patients with hepatocellular lack of blood supply carcinoma, also can prolong the survival time, they show poor safety.
期刊: 2017年第28卷第6期
作者: 陈鲁青,高志强,程会云,孙振友,高洪盛,贺光辉,赵允正
AUTHORS: CHEN Luqing,GAO Zhiqiang,CHENG Huiyun,SUN Zhenyou,GAO Hongsheng,HE Guanghui,ZHAO Yunzheng
关键字: 乏血供肝癌;奥沙利铂;丝裂霉素;多柔比星;肝动脉化疗栓塞;三维适形放疗;疗效;安全性
KEYWORDS: Lack of blood supply hepatocellular carcinoma; Oxaliplatin; Mitomycin; Doxorubicin; TACE; Three-dimensional conformal radiotherapy; Efficacy; Safety
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