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在西方国家,肝细胞癌(HCC)病人因一般情况不良、肝贮备功能差及年龄关系(>60岁)只有一小部分可行手术治疗。对不能手术治疗的病人,系统化疗和放疗对生存率均无有利影响。动脉插管化学栓塞疗法(TCE)适用于大部分病人。经管油剂化学栓塞(TOCE)即为此类局部治疗的一种且是HCC的一种有效姑息疗法。有关TOCE的西方资料尚少。本文报道127例不能手术治疗的HCC法国病人用TOCE治疗的结果并以127例未治疗病人作对照。TOCE方法:将20～60mg阿霉素,70～100mg顺铂或50～100mg表阿霉素与10ml或80ml碘油(Lipiodl)混合注入。栓塞术后只要转氨酶高于6～8N就予以强迫性利尿,每天至少3L,并用第三代头抱类抗生素预防性给药。
In western countries, patients with hepatocellular carcinoma (HCC) have only a small percentage of possible surgical treatments due to poor general conditions, poor liver reserve, and age (>60 years). For patients who cannot be treated surgically, systemic chemotherapy and radiotherapy have no beneficial effect on survival. Arterial cannula chemoembolization (TCE) is suitable for most patients. Transcatheter chemical embolism (TOCE) is one of these topical treatments and is an effective palliative treatment for HCC. There is little information about Western TOCE. This article reported the results of TOCE treatment in 127 French patients who could not be treated with HCC and compared 127 untreated patients. TOCE method: 20-60 mg of doxorubicin, 70-100 mg of cisplatin or 50-100 mg of epirubicin are mixed with 10 ml or 80 ml of lipiodol. Postoperatively, as long as the transaminase is higher than 6-8N, compulsive diuresis will be given after embolization, at least 3L per day, and prophylactic administration will be carried out with the third generation of headgear antibiotics.