Arsenic trioxide intravenous infusion combined with transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with pulmonary metastasis: Long-term outcome analysis
Arsenic trioxide intravenous infusion combined with transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with pulmonary metastasis: Long-term outcome analysis
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DOI：
10.1111/jgh.13529
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发表时间：
2017-02-01
影响因子：
4.1
通讯作者：
Geng, Xiang
中科院分区：
文献类型：
--
作者：
Hu, Hong Tao;Yao, Quan Jun;Geng, Xiang
目的评价三氧化二砷（As 2 O3）静脉滴注治疗肝细胞癌（HCC）肺转移的安全性、临床疗效和远期疗效。方法将60例确诊为晚期HCC肺转移的患者按1：1随机分为治疗组和对照组。治疗组先行肝动脉化疗栓塞术（TACE），再行As 2 O3治疗，对照组仅行TACE治疗。治疗组给予As 2 O3 10 mg/d静脉滴注，持续5 h。As 2 O3治疗在TACE后3- 5天开始（以使肝脏和胃肠道功能恢复），并连续14天。治疗组所有患者均接受至少4个疗程的治疗。结果治疗组完全缓解（CR）2例，部分缓解（PR）6例，稳定（SD）10例，进展（PR）12例。临床有效率（CR+PR）为26.7%，临床获益率（CR+PR+SD）为60%。在对照组中，没有患者达到CR或PR，5名患者达到SD，25名患者出现疾病进展。临床有效率为0%，临床受益率为16.7%。总的1年生存率治疗组为56.7%，对照组为36.7%。2年生存率治疗组为16.7%，对照组为3.3%.Conclusion肝动脉化疗栓塞联合As 2 O3静脉滴注能有效控制肝细胞癌患者的肺转移，与单纯肝动脉化疗栓塞相比，能延长患者的生存期。
ObjectiveTo evaluate the safety, clinical efficacy, and long-term outcome of arsenic trioxide (As2O3) intravenous infusion for pulmonary metastases in patients with HCC.Materials and MethodsSixty consecutive patients who were diagnosed with advanced hepatocellular carcinoma (HCC) with pulmonary metastasis were randomized 1:1 into the treatment and control groups. Treatment group underwent transcatheter arterial chemoembolization (TACE) for the primary liver tumor and then underwent As2O3 treatment, whereas control group underwent TACE alone. The treatment group underwent a continuous 5-h intravenous infusion of 10mg/day As2O3. The course of As2O3 treatment was initiated 3-5days after TACE (to allow liver and gastrointestinal function to recover) and continued for 14 consecutive days. All patients in the treatment group underwent at least four treatment courses. Response to treatment was evaluated after four treatment courses.ResultIn treatment group, two patients had a complete response (CR), six had a partial response (PR), 10 had stable disease (SD), and 12 had progressive disease. A clinically effective rate (CR+PR) was achieved in 26.7%, and the clinical benefit rate (CR+PR+SD) was 60%. In the control group, no patients had a CR or PR, five had SD, and 25 had progressive disease. The clinically effective rate was 0%, and the clinical benefit rate was 16.7%. The overall 1-year survival was 56.7% in treatment group and 36.7% in control group. The overall 2-year survival was 16.7% in treatment group and 3.3% in control group.ConclusionTranscatheter arterial chemoembolization plus an intravenous infusion of As2O3 effectively controlled pulmonary metastasis and prolonged overall survival in patients with HCC compared with TACE alone.