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目的 观察奥曲肽在不可切除肝癌治疗中的作用和临床效果。方法 选择 2 0 0 0年 1月至2 0 0 2年 12月收治不可切除的原发性肝癌 16例 ,采用肝动脉埋泵化疗加皮下注射奥曲肽治疗 (奥曲肽治疗组 ) ,并与 1995年 1月至 1999年 12月 15例单纯用肝动脉埋泵化疗治疗 (肝动脉化疗组 )和 14例单用静脉全身化疗治疗 (静脉化疗组 )两组病例相对照。结果 奥曲肽治疗组、肝动脉化疗组、静脉化疗组的近期总缓解率分别为 87 5 0 %、73 33%、5 7 14 %。奥曲肽治疗组明显高于静脉化疗组 (χ2 =6 6 96 ,P =0 0 10 )。生存率方面 ,半年生存率分别为 93 75 %、86 6 6 %和 5 7 14 % ,奥曲肽治疗组较高 ;1年生存率分别为 81 2 5 %、4 6 6 7%和 35 71% ,奥曲肽治疗组明显高于肝动脉化疗组 (χ2 =4 0 4 5 ,P =0 0 4 4 )和静脉化疗组 (χ2 =4 6 93,P =0 0 30 )。AFP的总下降率分别为 87 5 0 %、5 3 33%、5 0 0 0 % ,奥曲肽组AFP下降率明显高于其他两组(P =0 0 0 13,P =0 0 0 9)。结论 奥曲肽联合肝动脉埋泵化疗能明显提高不可切除肝癌的缓解率 ,改善病人生活质量 ,延长病人生存期 ,是一种新的有前途的治疗原发性肝癌的手段之一。
Objective To observe the effect and clinical effect of octreotide in the treatment of unresectable liver cancer. Methods Sixteen patients with unresectable primary liver cancer from January 2000 to December 2002 were enrolled in this study. The patients underwent hepatic artery infusion pump chemotherapy plus subcutaneous injection of octreotide (octreotide treatment group) From January to December 1999, 15 patients were treated with hepatic arterial infusion chemotherapy alone (hepatic artery chemotherapy group) and 14 patients with intravenous systemic chemotherapy alone (intravenous chemotherapy group). Results The total remission rates of octreotide, hepatic arterial chemotherapy and intravenous chemotherapy were 87.5%, 73.3% and 57.14% respectively. The octreotide treatment group was significantly higher than the intravenous chemotherapy group (χ2 = 6 6 96, P = 0 0 10). Survival rate, half-year survival rates were 93 75%, 86 6 6% and 5 7 14%, octreotide treatment group were higher; 1-year survival rates were 81 2 5%, 46 6 7% and 35 71% The octreotide treatment group was significantly higher than the hepatic artery chemotherapy group (χ2 = 4044, P = 0444) and the intravenous chemotherapy group (χ2 = 4693, P = 030). The total declining rate of AFP was 87.5%, 53.3% and 50.00% respectively. The declining rate of AFP in octreotide group was significantly higher than that in the other two groups (P = 0.0013, P = 0.090). Conclusions Octreotide combined with intra-arterial infusion pump chemotherapy can significantly improve the remission rate of unresectable hepatocellular carcinoma, improve patient quality of life and prolong patient survival. It is a new and promising method for the treatment of primary liver cancer.