摘要
目的 :观察磷微球治疗晚期肝癌的并发症并探讨其防治方法。方法 :1994年至 1998年 ,采用3 2 磷 -玻璃微球 (phosphorus- 32glassmicrospheres,3 2 P -GMS) 2 6 - 17 9mCi,术中栓塞法附加肝动脉结扎及置管化疗 2 3例 (OAE +HAL) ,经Seldinger导管栓塞法 2 1例 (TAE) ,以纯甘油或碘化油作媒介加化疗药制成放化疗综合性栓塞液。结果 :全组OAE +HAL组副反应高于TAE组 ;均无骨髓抑制和肾毒性 ;肝功能指标多呈一过性改变 ,4例肝功恶化 ;肺、脾、胆、胰异位栓塞各为 2、1、4、2例。 4 4例肿瘤缩小率为 4 6 7± 2 4 5 % (0 - 91 8% ) ,9/2 3例癌栓缩小 ,2 5 /2 7例AFP下降 ,肿瘤稳定期 5 3± 3 9月 ,平均生存 12 5± 9 2月。结论 :3 2 P -GMS可成为治疗肝癌安全有效的临床医用生物材料。良好的病例选择、合理的内照射剂量是有效降低术后近期并发症和提高远期疗效的关键。
Objective:To survey the complication and efficacy of selective internal radioembolization using phosphorus-32 glass micr ospheres combined with chemoembolization for advanced liver cancer.Methods:From 1 994 to 1998,44 patients with unresectable liver cancer(39 primary and 5 metastat ic)recieved combined radio-chemo-embolization with mixed emulsion of 3 2 p -GMS(8 8±4 2 or 2 6-17 9 mCi),chemo-agent(Adr 20 mg,5-Fu 1 g and Mmc 1 0 mg) and glycerine or lipiodol(average 14 or 12 ml),via intra-operative hepatic arter y instillation(23 cases,following hepatic artery ligation,OAE+HAL)or transcathet er hepatic artery embolization(21cases,TAE).Results:There was no significant bon e marrow or renal toxicity,longitudinal gastrointestinal tract reaction and trans ient change of liver function test occurred in almost all patients while liver d ysfunction happened in four cases,pulmonary,splenic,cerebral,pancreatic and gall bladder embolization were seen in 2,1,1,4 and 2 cases respectively;moreover,the toxicity was more taken place in OAE group.The tumor shrinking rate were 46 7± 24 5%(0-91 8%)and the average survival time for those patients were 12 5±9 2 month.Conclusion:The combined radio-chemo-embolization appears to be more effe ctive and safe by and large.The reasonable internal radiation doses,preoperativ e selection of patients and intra-operative skill were very important to either reduce the short-term complication or enhance the chance of long-term survival.
出处
《华西医学》
CAS
2002年第1期29-31,共3页
West China Medical Journal
基金
李志辉 (1 969年 - )
男
河南郑州市人
在读外科学博士
关键词
肝癌
内照射治疗
并发症
s:Liver neoplasm
Internal radiation th erapy
complication
