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1、沙利度胺聯(lián)合肝動(dòng)脈化療栓塞治療中晚期肝癌臨床研究尚巖,陳明聰,江慧斌,徐學(xué)明,劉樹勛尚巖,1989年畢業(yè)于江蘇徐州醫(yī)學(xué)院醫(yī)療系,副主任醫(yī)師,主要從事腫瘤化放療和介入研究通訊作者:尚巖浙江省溫嶺市新河鎮(zhèn)渡南頭開發(fā)區(qū)第二人民醫(yī)院腫瘤內(nèi)科317502E-mail:doctorsyzhj@sina.com固定電話:13867679718摘要目的:探討沙利度胺(TLD)聯(lián)合肝動(dòng)脈化療栓塞(TACE)治療中晚期原發(fā)性肝癌的臨床療效及不良反應(yīng)。方法:120例患者隨機(jī)分為觀察組和對(duì)照組各60例,觀察組在TACE基礎(chǔ)上加口服TLD,對(duì)照組不用TLD。結(jié)果:
2、近期療效顯示觀察組腫瘤完全緩解(CR)8例,部分緩解(PR)45例,無變化(NC)4例,進(jìn)展(PD)3例,總有效率為88.3%(p<0.05)。兩組未見嚴(yán)重不良反應(yīng)發(fā)生。隨訪3年,觀察組1、2、3年生存率分別為73.3%、56.7%、36.7%;對(duì)照組為46.7%、30.0%、13.3%(p<0.05)。結(jié)論:應(yīng)用TLD聯(lián)合TACE治療中晚期原發(fā)性肝癌療效明顯,不良反應(yīng)輕,具有一定的臨床應(yīng)用價(jià)值。關(guān)鍵詞:原發(fā)性肝癌;沙利度胺;肝動(dòng)脈化療栓塞中圖分類號(hào):文獻(xiàn)標(biāo)識(shí)碼:文章編號(hào):Theclinicalstudyoftranscatheterar
3、terialchemoembolizationcombinedwiththalidomideonadvancedhepaticcarcinomaSHANGYan,CHENMing-Cong,JIANGHui-Bin,XUXue-ming,LIUSHu-Xun,CHENDe-LianTaizhouCancerHospitalofZhejiangProvince,Wenling317502,Zhejiang,China.ABSTRACT:AIMToobservetheeffectoftranscatheterarterialchemoembo
4、lizationcombinedwiththalidomide(TLD)onadvancedhepaticcarcinoma.METHODS120advancedhepaticcarcinomapatientswereassignedto2groups.TLDgroupweretreatedbytranscatheterarterialchemoembolizationcombinedwithTLD,andcontrolgroupwereonlytreatedbyTACE.Themainoutcomemeasurewastherespon
5、serateandtoxinresponse;secondaryoutcomeswasoverallsurvivalrate.RESULTSTheoverallresponseratewas88.3percentintheTLDgroupand63.3percentinthecontrolgroup(p<0.05).Therewasnotseverelyside-effectinthebothgroups.Theoverall1,2,3-yearsurvivalrateswere73.3%,56.7%and36.7%intheTLDgro
6、up,and46.7%,30.0%and13.3%inthecontrolgroup.Thereweresignificantdifferencesofthe2-and3-yearsurvivalratebetweentheTLDgroupandthecontrolgroup(p<0.05).CONCLUSIONSCombinedthalidomidewithTACEismoreeffectivethantranscatheterarterialchemoembolizationcombinedalonefortheadvancedhep
7、atocellularcarcinoma.Itsadverseeffectsaretolerable,soithascertainvalueforclinicalapplication.KEYWORDShepatocellularcarcinoma,thalidomide,transcatheterarterialchemoembolizationcombined肝細(xì)胞性肝癌(HCC)是我國(guó)高發(fā)的惡性腫瘤,發(fā)病率位居惡性腫瘤第3位,死亡率居第2位。其自然生存期在確診后一般為2~4個(gè)月。盡管HCC外科治療有了很大進(jìn)展,且早期手術(shù)切除目前仍是
8、最有效的治療方法,但由于臨床就診的患者大都已到了中晚期,只有10%~30%適合手術(shù)治療,對(duì)失去了手術(shù)治療機(jī)會(huì)的大多數(shù)患者,肝動(dòng)脈化療栓塞(TACE)是目前公認(rèn)的首選治療方法之一[1],但遠(yuǎn)期療