【摘要】 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。更多还原

【Abstract】 Objective To evaluate the therapeutic effect of elemene emulsion via implanted Port-catheter drug delivery system(PCDDS)in patients with non-resectable liver metastases.MethodsFrom 1997 to 2006,31 patients with non-resectable liver metastases received element emulsion combined DDP,ADM,5-FU/CF via PDDS hepatic intra-arterial infusion chemotherapy.(Chemotherapy regimen:ADM 40 mg/m2 d1,q4～6w,DDP 40 mg/m2 d1,q4～6w,5-FU 1000 mg/m2 d2～3 24 hours continue infusion by mini-pump q4～6w,Folic acid 300 mg via vein transfuse for 3 hours before 5-FU d2 q4～6w,5-FU 167 mg/(m2·day)continuously for 3 months and then 334 mg/m2 qw,Elemene emulsion 300 mg/d d1～20 q4～6w).ResultsAfter 2～10(185 cycles/31 patients,average 6.5 cycles)cycles of chemotherapy,Response rates evaluated by CT-scan were 71.0%(2 CR+20 PR/31).The survival time ranged from 3.52 to 43.2 months(median 17.6 months).1-year and 2-year overall survival rates were 65.23%and 32.65%。3 patients experienced grade 3～4 digestive side-effect.Four patients displayed grade 3～4 neutropenia.There were grade 3～4 damage of liver in three patients.There were no severe damage of kidney and heart.One patient had to be extubated because of the catheter’s weeping.There were no other catheter-related complications.The life quality of 23 patients had increased.ConclusionLemene emulsion continuity intra-arterial infusion chemotherapy with PCDDS for non-resectable liver metastases is safe and effective and merits further evaluation.更多还原