华蟾素注射液经肝动脉灌注联合碘油栓塞治疗巴塞罗那C期原发性肝癌的效果和安全性

于童; 翟笑枫; 刘群; 孟永斌; 陆检英; 陈喆

doi:10.3969/j.issn.1001-5256.2017.02.015

华蟾素注射液经肝动脉灌注联合碘油栓塞治疗巴塞罗那C期原发性肝癌的效果和安全性

DOI: 10.3969/j.issn.1001-5256.2017.02.015

1. 上海中医药大学
2. 第二军医大学附属长海医院中医肿瘤科
3. 合肥静安中西医结合医院肿瘤科

基金项目:

上海市中医药事业发展三年行动计划(ZY3-LCPT-2-1004;ZY3-CCCX-3-7002)；长海医院1255学科建设计划课题(CH125521200)；上海市科学技术委员会医学引导项目(15401931700)；

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2016-10-08
- 出版日期: 2017-02-20

Clinical effect and safety of hepatic arterial infusion of cinobufotalin injection combined with lipiodol chemoembolization in treatment of Barcelona Clinic Liver Cancer stage C primary liver cancer

Shanghai University of Traditional Chinese Medicine

Research funding:

摘要

摘要: 目的观察华蟾素注射液经肝动脉灌注联合碘油栓塞治疗巴塞罗那C期原发性肝癌的疗效和安全性。方法回顾性分析2010年12月-2014年10月长海医院中医肿瘤科收治的巴塞罗那C期原发性肝癌患者共82例,根据术中用药不同分为2组,其中华蟾素组40例,采用华蟾素肝动脉灌注及碘油栓塞;对照组42例,采用表阿霉素行经肝动脉化疗栓塞术（TACE）治疗。行单次治疗后,比较2组患者的客观缓解率、疾病进展时间、中位生存期和急性不良反应。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验,累计生存率采用Kaplan-Meier法。结果术后1.5个月时,华蟾素组客观缓解率为27.5%,优于对照组的9.52%（χ2=4.429,P=0.035）;华蟾素组疾病进展时间为2.4个月[95%可信区间（95%CI）:1.9782.822],对照组为3.0个月（95%CI:2.2603.740）,2组比较差异无统计学意义（P=0.344）;华蟾素组中位生存期为6.6个月（95%CI:4.1319.069）,对照...
- 肝肿瘤 /
- 化学疗法,肿瘤,局部灌注 /
- 化学栓塞,治疗性 /
- 华蟾素注射液 /
- 治疗结果
Abstract: Objective To investigate the clinical effect and safety of hepatic arterial infusion of cinobufotalin injection combined with lipiodol chemoembolization( TACE) in the treatment of Barcelona Clinic Liver Cancer( BCLC) stage C primary liver cancer.Methods A retrospective analysis was performed for the clinical data of 82 patients with BCLC stage C primary liver cancer who were admitted to Department of TCM Oncology in Changhai Hospital from December 2010 to October 2014.According to intraoperative medication,the patients were divided into two groups.The 40 patients in the cinobufotalin group were treated with hepatic arterial infusion with cinobufotalin combined with lipiodol embolism,and the 42 patients in the control group underwent TACE with epirubicin.The objective response rate,time to progression,median survival time,and acute adverse events were compared between the two groups after a single treatment.The t- test was used for comparison of continuous data between groups,the chi- square test was used for comparison of categorical data between groups,and the Kaplan- Meier method was used for the analysis of cumulative survival rate.Results At 1.5 months after surgery,the cinobufotalin group had a significantly higher objective response rate than the control group( 27.5% vs 9.52%,χ~2= 4.429,P = 0.035).The time to progression was 2.4 months( 95% CI:1.978- 2.822) in the cinobufotalin group and 3.0 months( 95% CI:2.260- 3.740) in the control group,and there was no significant difference between the two groups( P = 0.344).The median survival time was 6.6 months( 95% CI:4.131-9.069) in the cinobufotalin group and 10.3 months( 95% CI:0.089- 20.511) in the control group,and there was no significant difference between the two groups( P = 0.132).At 5 days after surgery,the cinobufotalin group had significantly lower incidence rates of abnormal alanine aminotransferase level,white blood cell count,and platelet count,as well as adverse events including hepatalgia,abdominal distension,and nausea / vomiting than the control group( χ~2= 6.193,5.311,6.096,5.909,4.761,and 4.173,all P < 0.05).Conclusion As for patients with BCLC stage C primary liver cancer,hepatic arterial infusion of cinobufotalin injection combined with lipiodol chemoembolization has a better short- term therapeutic effect,milder adverse effects,and a similar long- term therapeutic effect compared with TACE with conventional chemotherapeutic agents.
- liver neoplasms /
- chemotherapy /
- cancer /
- regional perfusion /
- chemoembolization

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参考文献(24)

[1]TORRE LA,BRAY F,SIEGEL RL,et al.Global cancer statistics,2012[J].CA Cancer J Clin,2015,65(2):87-108.

[2]LLOVET JM,BURROUGHS A,BRUIX J.Hepatocellular carcinoma[J].Lancet,2003,362(9399):1907-1917.

[3]LLOVET JM,BRU C,BRUIX J.Prognosis of hepatocellular carcinoma:the BCLC staging classification[J].Semin Liver Dis,1999,19(3):329-338.

[4]CHUNG GE,LEE JH,KIM HY,et al.Transarterial chemoembolization can be safely performed in patients with hepatocellular carcinoma invading the main portal vein and may improve the overall survival[J].Radiology,2011,258(2):627-634.

[5]SATORU M,TAKAHIKO M,FUMIE S,et al.Interventional treatment for unresectable hepatocellular carcinoma[J].World J Gastroenterology,2014,20(37):13453-13465.

[6]BRUIX J,LLOVET JM,CASTELLS A,et al.Transarterial embolization versus symptomatic treatment in patients with advanced hepatocellular carcinoma:results of a randomized,controlled trial in a single institution[J].Hepatology,1998,27(6):1578-1583.

[7]LIU Y,LI GY,ZHAO XX,et al.Research advances in traditional Chinese medicine combined with interventional therapy for hepatocellular carcinoma[J].J Clin Hepatol,2015,31(1):118-122.(in Chinese)刘洋,李桂英,赵相轩,等.中药结合介入手段治疗肝癌的研究进展[J].临床肝胆病杂志,2015,31(1):118-122.

[8]CAO YJ,YANG JK,YANG JZ.Research advance in treatment of primary liver cancer with Cinobufacini injection[J].Shanghai JTradit Chin Med,2012,46(4):86-88.(in Chinese)曹亚娟,杨金坤,杨金祖.华蟾素注射液治疗原发性肝癌研究进展[J].上海中医药杂志,2012,46(4):86-88.

[9]WANG LL,ZHANG YH,CHEN XY.AASLD Practice guideline:management of hepatocelluar carcinoma[J].Beijing Med J,2011,33(3):236-251.(in Chinese)王莉琳,张永宏,陈新月.2010年美国肝病年会(AASLD)肝细胞癌诊疗指南[J].北京医学,2011,33(3):236-251.

[10]LENCIONI R,LLOVET JM.Modified RECIST(mRECIST)assessment for hepatocellular carcinoma[J].Semin Liver Dis,2010,30(1):52-60.

[11]HAN K,KIM JH.Transarterial chemoembolization in hepatocellular carcinoma treatment:Barcelona clinic liver cancer staging system[J].World J Gastroenterology,2015,21(36):10327-10335.

[12]CHO JY,PAIK YH,PARK HC,et al.The feasibility of combined transcatheter arterial chemoembolization and radiotherapy for advanced hepatocellular carcinoma[J].Liver Int,2014,34(5):795-801.

[13]IZUMI R,SHIMIZU K,MIYAZAKI I.Postoperative adjuvant locoregional chemotherapy in patients with hepatocellular carcinoma[J].Hepatogastroenterology,1996,43(12):1415-1420.

[14]SHIM JH,PARK JW,KIM JH,et al.Association between increment of serum VEGF level and prognosis after transcatheter arterial chemoembolization in hepatocellular carcinoma patients[J].Cancer Science,2008,99(10):2037-2044.

[15]RANIERI G,AMMENDOLA M,MARECH I,et al.Vascular endothelial growth factor and tryptase changes after chemoembolization in hepatocarcinoma patients[J].World J Gastroenterol,2015,21(19):6018-6025.

[16]KAWAI S,OKAMURA J,OGAWA M,et al.Prospective and randomized clinical trial for the treatment of hepatocellular carcinomaa comparison of lipiodol-transcatheter arterial embolizaion with and without adriamycin(first cooperative study)[J].Cancer Chemother Pharmacol,1992,31(Suppl):s1-s6.

[17]MALAGARI K,POMONI M,KELEKIS A,et al.Prospective randomized comparison of chemoembolization with doxorubicin-eluting beads and bland embolization with Bead Block for hepatocellular carcinoma[J].Cardiovasc Intervent Radiol,2010,33(3):541-551.

[18]WANG SS,LI B,ZHAI XF.Research advances in antitumor effect of cinobufotalin injection and related mechanism[J].J Shandong Univ Tradit Chin Med,2008,32(5):436-438.(in Chinese)王双双,李柏,翟笑枫.华蟾素注射液抗肿瘤应用及其机制研究进展[J].山东中医药大学学报,2008,32(5):436-438.

[19]JI JF,DENG XL,XIAO QJ,et al.Percutaneous cinobufotalin injection under ultrasonography combined with transcatheter arterial chemoembolization on treating portal vein tumor thrombus[J].JChangchun Univ Chin Med,2015,31(5):1059-1062.(in Chinese)冀建峰,邓晓莉,肖秋金,等.超声介入华蟾素联合肝动脉化疗栓塞治疗门静脉癌栓[J].长春中医药大学学报,2015,31(5):1059-1062.

[20]LI Q,SUN BM,PENG YH,et al.Clinical study on the treatment of primary liver cancer by cinobufotain combined with transcatheter arterial chemoembolization[J].Acta Univ Tradit Med Sin Pharmacol Shanghai,2008,22(2):32-34.(in Chinese)李琦,孙保木,彭永海,等.华蟾素联合肝动脉介入化疗栓塞治疗原发性肝癌的临床研究[J].上海中医药大学学报,2008,22(2):32-34.

[21]DONG HJ,ZHANG LJ,ZHAI XF,et al.Effects of different nursing methods in treatment of phlebitis caused by cinobufacini injection[J].J Chin Integr Med,2007,5(5):585-587.(in Chinese)董惠娟,张玲娟,翟笑枫,等.不同护理方法防治华蟾素所致静脉炎的效果观察[J].中西医结合学报,2007,5(5):585-587.

[22]HANKS BA,SUHOCKI PV,DELONG DM,et al.The efficacy and tolerability of transarterial chemo-embolization(TACE)compared with transarterial embolization(TAE)for patients with unresectable hepatocellular carcinoma(HCC)[J].J Clin Oncol,2008,26(15):4595.

[23]ZHOU LH,HOU YM,LI XF.Adverse effects of cinobufotalin injection and related nursing strategies[J].J Guangxi Med Univ,2016,33(2):375-376.(in Chinese)周柳红,候毅梅,黎绣芬.华蟾素注射液治疗中出现的不良反应及护理对策[J].广西医科大学学报,2016,33(2):375-376.

[24]SHEN JJ.Clinical effect of interventional embolization combined with intravenous injection of cinobufotalin in treatment of primary liver cancer[J].J Clin Hepatol,2009,25(3):207-209.(in Chinese)沈建军.华蟾素介入栓塞联合静脉注射对原发性肝癌的临床疗效[J].临床肝胆病杂志,2009,25(3):207-209.

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