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目的探讨卡莫氟配合经肝动脉灌注化疗栓塞(TACE)治疗中晚期原发性肝癌的疗效。方法90例肝癌患者采用同期配对法分成两组,综合治疗组(试验组)45例,采用TACE+卡莫氟,末次TACE术后2周口服卡莫氟,每次200 mg,每日3次,两周为1周期,间隔2周进行下一周期,共2~4周期;对照组45例,单纯采用TACE。TACE方案选择顺铂(DDP)60~100 mg、丝裂霉素(MMC)12~20 mg、5-Fu 1 000~1 500 mg,再将表柔比星(表阿霉素,EPI)50~70 mg与超液化碘油10~20 ml充分混合成乳剂缓缓注入,然后用1~2 mm的明胶海绵栓塞供血动脉,两组均行TACE2~3次。结果综合组(试验组)近期有效率91.1%,对照组60.0%,两组差异有非常显著性(χ2=11.79,P<0.01),综合组1,2,3,5年生存率分别为88.9%、55.6%、33.3%和20.0%,对照组分别为51.1%、37.8%、20.0%和0(χ2=6.65,P<0.01),中位生存期分别为27.3和16.7个月(χ2=4.75,P<0.05)。肝功能A级和B级3年生存率分别为48.3%和6.3%(χ2=8.195,P<0.01);5年生存率分别为31.0%和0,χ2=4.42,P<0.05)。结论卡莫氟配合TACE为较好的治疗原发性肝癌的方法。
Objective To investigate the efficacy of carmofur combined with transcatheter arterial chemoembolization (TACE) in the treatment of advanced primary liver cancer. Methods Ninety patients with hepatocellular carcinoma (HCC) were divided into two groups according to the same-time pairing method. The patients in the combined treatment group (experimental group) received TACE + Carmofur and were given carmofurin 200 mg twice daily for 3 weeks after the last TACE. Two weeks for a cycle, two weeks intervals for the next cycle, a total of 2 to 4 cycles; control group of 45 patients, simply using TACE. In the TACE regimen, 60-100 mg of cisplatin (DDP), 12-20 mg of mitomycin (MMC), and 1 500-1 500 mg of 5-Fu were selected. Epirubicin (EPI) 50 ~ 70 mg and ultra-liquefied iodized oil 10 ~ 20 ml mixed into the emulsion slowly injected, and then with 1 ~ 2 mm gelatin sponge embolization of the feeding artery, two groups were TACE 2 ~ 3 times. Results The effective rate of the comprehensive group (experimental group) was 91.1%, while that of the control group was 60.0%. There was significant difference between the two groups (χ2 = 11.79, P <0.01). The 1-, 2-, 3-, 5-year survival rates of the integrated group were 88.9 %, 55.6%, 33.3% and 20.0% in the control group and 51.1%, 37.8%, 20.0% and 0 in the control group (χ2 = 6.65, P <0.01). The median survival time was 27.3 and 16.7 months , P <0.05). The 3-year survival rates of grade A and grade B were 48.3% and 6.3%, respectively (χ2 = 8.195, P <0.01). The 5-year survival rates were 31.0% and 0 respectively, χ2 = 4.42, P <0.05. Conclusion Carmofur with TACE is a better treatment of primary liver cancer.