腹腔化疗或联合其他方法综合治疗晚期原发性肝癌72例的疗效观察(英文)

来源 :Chinese-German Journal of Clinical Oncology | 被引量 : 0次 | 上传用户:wzy1023
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Objective: To evaluate the effect of intraperitoneal chemotherapy or in combination with other therapies in pa- tients with advanced primary liver cancer. Methods: 72 patients with advanced primary liver cancer with no indication for surgery received intraperitoneal chemotherapy in combination with other therapies including transcatheter arterial chemoem- bolization (TACE), radiofrequency catheter ablation (RFA), percutaneous ethanol injection therapy (PEIT) and radiotherapy. Of them, 29 cases were complicated with hilar or retroperitoneal multiple lymph node metastases, 14 with portal vein em- bolus, 15 with intraperitoneal and diaphragmatic metastases, 6 with chylous ascites, one with cancerous ascites, and 7 with suspected cancerous ascites (referring to large amounts of ascites without hypoproteinemia while exfoliative cytology of the ascites was positive). The mean maximum tumor size was 8.2 cm in diameter. Liver function at the initial treatment was Child A in 53 cases, and Child B in 19 cases. Intraperitoneal chemotherapy was performed in all these patients. The intraperitoneal chemotherapy protocols included: 5-FU 0.5-0.75 g/d for 10-15 consecutive days, with a total dosage of 5-12.5 g, and at the last day of chemotherapy 10 mg mitomycin (MMC) or 100 mg carboplatin was injected. For 7 cases of cholangiocarcinoma, Gemzar 800-1000 mg was administered additionally. A majority of all these patients received another one or two therapy methods followed by intraperitoneal chemotherapy. TACE was performed in the patients with multiple tumors or nodule more than 5 cm in diameter in the liver, RFA or PEIT with nodule fewer than 4 in number and 5 cm or less than 5 cm in diameter and radiotherapy, only for metastases, with metastatic lymph nodes, localized metastasis within the abdominal cavity or portal vein embolus. Interval time between two methods was one month or so. Two months after the sequential therapy, repeated treatment would be given if general medical condition and liver function were perfect at that time. Results: The median sur- vival time of the group was 13.97 ± 6.27 months. The 1- and 2-year survival rates were 59.7% and 30.6% respectively. The mean survival time of the patients with liver function Child A was 15.91 ± 5.49 months, and that of the patients with Child B was 8.55 ± 5.09 months. The difference was statistically significant (P < 0.05). Conclusion: Intraperitoneal chemotherapy or in combination with other therapies in patients with advanced primary liver cancer with metastases to abdominal cavity is an effective method. It can prolong the survival time and improve life quality for a certain percentage of patients with advanced primary liver cancer. Objective: To evaluate the effect of intraperitoneal chemotherapy or in combination with other therapies in pa- tients with advanced primary liver cancer. Methods: 72 patients with advanced primary liver cancer with no indication for surgery received intraperitoneal chemotherapy in combination with other therapies including transcatheter arterial Of them, 29 cases were complicated with hilar or retroperitoneal multiple lymph node metastases, 14 with portal vein em- bolus, 15 with intraperitoneal and diaphragmatic metastases, 6 with chylous ascites, one with cancerous ascites, and 7 with suspected cancerous ascites (referring to large amounts of ascites without hypoproteinemia while exfoliative cytology of the ascites was positive). The mean maximum tumor size was 8.2 cm in diameter Liver function at the initial treatment was Child A in 53 cases, and Child Intraperitoneal chemotherapy was performed in all these patients. The intraperitoneal chemotherapy protocols included: 5-FU 0.5-0.75 g / d for 10-15 consecutive days, with a total dosage of 5-12.5 g, and at the last day of chemotherapy 10 mg mitomycin (MMC) or 100 mg carboplatin was injected. For 7 cases of cholangiocarcinoma, Gemzar 800-1000 mg was administered plus. A majority of all these patients received another one or two therapy methods followed by intraperitoneal chemotherapy. TACE was performed in the patients with multiple tumors or nodules more than 5 cm in diameter in the liver, RFA or PEIT with nodules less than 4 in number and 5 cm or less than 5 cm in diameter and radiotherapy, only for metastases, with metastatic lymph nodes, localized metastasis within the abdominal cavity or portal vein embolus. Interval time between two methods was one month or so. Two months after the sequential therapy, repeated treatment would be given if general medical condiResults and liver function were perfect at that time. Results: The median survival time of the group was 13.97 ± 6.27 months. The 1- and 2-year survival rates were 59.7% and 30.6% respectively. The mean survival time of the Patients with liver function Child A was 15.91 ± 5.49 months, and that of the patients with Child B was 8.55 ± 5.09 months. The difference was statistically significant (P <0.05). Conclusion: Intraperitoneal chemotherapy or in combination with other therapies in patients with advanced primary liver cancer with metastases to abdominal cavity is an effective method. It can prolong the survival time and improve life quality for a certain percentage of patients with advanced primary liver cancer.
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