CAJ | 학술논문

目的：观察GP方案联合IL-2、IFNα-2b行TACE治疗原发性肝癌的近期疗效、远期生存与不良反应。方法：对208例原发性肝癌患者在 DSA 引导下行 TACE 治疗，造影确定靶血管后，先灌注吉西他滨（Gem）800-1200mg、顺铂（CDDP）60-80mg，其后再将Gem 200-400mg、CDDP 20-40mg、干扰素9×106 IU、白介素-23×106 IU与超液化碘油8-20ml充分混匀后在透视下进行栓塞。每月1次，本观察患者至少做3次，3次治疗后1月内采用mRECIST评价疗效。随访截止时间2012年3月。结果：208例PLC患者中，行TA-CE3次58例，4次88例，5次41例，6次12例。乏血供者37例，富血供者171例。平均无疾病进展时间为7．9个月，中位生存期为23．3个月；RR（133例）为63．9％，DCR（164例）为78．8％，Ⅱ期DCR最高（88％）。半年、1年、2年、3年生存率分别为87．5％、74．5％、49．0％、22．1％。常见的不良反应主要是发热、肝区疼痛、恶心或呕吐、食欲下降，以及白细胞、血小板减少，多为Ⅱ-Ⅲ级，无治疗相关死亡。结论：以GP方案联合IL-2、IFNα-2b行TACE治疗原发性肝癌是一种药物选择合理、疗效较佳、不良反应较轻、可行的治疗方法。
목적：관찰GP방안연합IL-2、IFNα-2b행TACE치료원발성간암적근기료효、원기생존여불량반응。방법：대208례원발성간암환자재 DSA 인도하행 TACE 치료，조영학정파혈관후，선관주길서타빈（Gem）800-1200mg、순박（CDDP）60-80mg，기후재장Gem 200-400mg、CDDP 20-40mg、간우소9×106 IU、백개소-23×106 IU여초액화전유8-20ml충분혼균후재투시하진행전새。매월1차，본관찰환자지소주3차，3차치료후1월내채용mRECIST평개료효。수방절지시간2012년3월。결과：208례PLC환자중，행TA-CE3차58례，4차88례，5차41례，6차12례。핍혈공자37례，부혈공자171례。평균무질병진전시간위7．9개월，중위생존기위23．3개월；RR（133례）위63．9％，DCR（164례）위78．8％，Ⅱ기DCR최고（88％）。반년、1년、2년、3년생존솔분별위87．5％、74．5％、49．0％、22．1％。상견적불량반응주요시발열、간구동통、악심혹구토、식욕하강，이급백세포、혈소판감소，다위Ⅱ-Ⅲ급，무치료상관사망。결론：이GP방안연합IL-2、IFNα-2b행TACE치료원발성간암시일충약물선택합리、료효교가、불량반응교경、가행적치료방법。
Objective:Observing the recent curative effect,the long-term survival and adverse reactions of using GP scheme combined IL-2,IFNα-2b with TACE for the treatment of primary liver cancer.Methods:Firstly,to treat 208 cases of primary liver cancer with TACE under DSA guidance.After screening to determine target blood vessels, perfuse gemcitabine 800-1200mg,cisplatin 60-80mg,and then mix Gem 200-400mg,CDDP 20-40mg,interferon 9 ×106 IU,interleukin-2 3 ×106 IU with super liquid Iodine oil 8 -20ml for embolization.Patients were treated at least 3 times.Results:In the 208 cases of PLC,there were 58 cases used TACE treatment for 3 times;88 cases for 4 times;41 cases for 5 times and 12 cases for 6 times.There were 37 cases lacking of blood donor and 171 cases riching in blood donor.The average month of progression of no disease was 7.9 months and the median survial time was 23.3 months.RR(133 cases)was 63.9%,DCR(164 cases)was 78.8%,and stage Ⅱ DCR was the highest (88%).The survival rates of 6 months,1 year,2 years,3 years were 87.5%,74.5%,49.0% and 22.1%,respec-tively.Common adverse reactions were mainly fever,liver pain,nausea or vomiting,loss of appetite,white blood cells, thrombocytopenia,and mostlyⅡ-Ⅲ level,no treatment-related death.Conclusion:Using GP scheme combined IL-2,IFNα-2b with TACE for the treatment of primary liver cancer is a feasible method,which has an reasonable drug selection,better curative effect,and lighter adverse reaction.