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目的观察化疗兼内照射的新型双弹头免疫导向治疗肝癌的疗效．方法以马抗人ＡＦＰ多克隆抗体（抗ＡＦＰＡｂ）和大鼠抗人ＡＦＰ单克隆抗体（抗ＡＦＰＭｃＡｂ）为载体，核素１３１Ｉ和丝裂霉素（ＭＭＣ）为双弹头，采用改良氯胺Ｔ法制备１３１Ｉ抗ＡＦＰＭｃＡｂＭＭＣ（双弹头１）和１３１Ｉ抗ＡＦＰＡｂＭＭＣ（双弹头２），静脉滴注，每月１次，治疗不能切除中晚肝癌３１例（治疗组）．治疗１，２，３次分别占４，１７和１０例，放射剂量（ＭＢｑ／例）均值依次为１９３５１±３７７４，６５１９±２３２４和９９２０±２３０５．结果治后肿瘤缩小率、血清ＡＦＰ下降率和１，２年生存率分别高于同期经动脉插管灌注（ＴＡＩ）或化疗栓塞（ＴＡＣＥ）的对照组（５００％，１５／３０比３００％，９／３０Ｐ＜００５；６６７％，１８／２７比２８０％，７／２５Ｐ＜００１和５００％比３３０％，３４０％比３３％Ｐ＜００１），治疗组病例的进展率（１００％）明显低于对照组（４００％，Ｐ＜００１）．结论双弹头疗效提高，由于抗体、核素１３１Ｉ和抗癌药的协同作用而增强了对癌细胞的杀伤力所致．
2. Objective To observe the efficacy of a new double - warhead immunoadjuvant chemotherapy and internal irradiation in the treatment of liver cancer. METHODS: Horse anti-human AFP polyclonal antibody (anti-AFPAb) and rat anti-human AFP monoclonal antibody (anti-AFPMcAb) were used as carriers. The radionuclide 131I and mitomycin (MMC) were double warheads. The modified chloramine T method was used. Preparation 131I anti-AFPMcAb-MMC (dual warhead 1) and 131I anti-AF-PAb-MMC (double warhead 2), intravenous infusion once a month, treatment of unresectable middle and late hepatocellular carcinoma in 31 cases (treatment group). Treatment 1, 2, and 3 times accounted for 4, 17 and 10 cases respectively. The mean dose of radiation dose (MBq/case) was 19351±3774,6519±2324 and 9920±2305. Results After treatment, tumor shrinkage rate, serum AFP decrease rate, and 1-year survival rate were higher than those of control group with transcatheter arterial infusion (TAI) or chemoembolization (TACE) at the same time (50.0%, 15/30, 30, respectively). 0%, 9/30P<005; 667%, 18/27 to 280%, 7/25P<001 and 500% to 330%, 340% to 3 3%P<001), the progress rate of the treatment group (100%) was significantly lower than that of the control group (400%, P<001). Conclusion The efficacy of double warheads is improved, due to the synergy of antibodies, radionuclide 131I and anticancer drugs, which enhances the lethality to cancer cells.