摘要
目的探讨经肝动脉灌注131I-HAb18F(ab’)2治疗肝癌合并门脉癌栓的价值。方法8例合并门脉癌栓的晚期肝癌患者行经肝动脉超选择灌注131I-HAb18F(ab')2临床治疗性试验,剂量:0.75mCi/kg。分析症状、卡氏评分、肝功能、AFP及肿瘤CT等影像变化,随访近期疗效。结果7例疼痛患者中,3例症状缓解。3例卡氏评分增加、4例稳定。6例AFP异常患者治疗后3例下降。全组病例用药后肝功能损害均无明显加重。1例无明显症状的弥漫型肝癌患者治疗后病灶减少;余7例中,瘤体增大5例、缩小2例,其中,PR2例,临床有效率28.6%。本组1例1年随访时生存。结论经肝动脉灌注0.75mCi/kg131I-HAb18F(ab')2对合并门脉癌栓的肝癌患者肝功影响小,对门脉分支癌栓患者有较好的疗效。
Objective To analyze the clinical effects of ^131I-HAbl8F （ab＇）2 radioimmunotherapy via hepatic artery on PLC with portal vein tumor emboli. Methods Under the condition of thyroid protection and negative dermal sensitivity test, 12 times of intraarterial injection with ^131 I labeled murine HCC monoclonal antibody fragment HAbl8F （ab＇）2 were performed in 8 patients of PLC complicated with portal vein tumor emboli. A 0.75 mCi/kg dose of ^131 I was administrated individually into certain target vessel after hepatic artery angiography using Seldinger technique. Results 3 of 7 patients with symptoms of pains showed remission with simultaneous improvement and stabilization in Kamofsky score in 3 and 4 patients respectively. AFP levels decreased about 50%（3/6）in 3 cases among those 6 positives and the values of I.B. and ALT changed within a very narrow range to a certain extent after the treatment. The overall rate of CR ＋ PR was 28.6% and similar better result was obtained in a non-symptomatic diffuse PLC patient.1 year survival rate was 12.5%. Conclusion ^131I-HAbl8F（ab＇）2 radioimmunotreating drug（0.75 mCi/kg）with hypotoxicity to liver-function can be used as an acceptable method for unresectable PLC with portal vein tumor emboli, especially for those without tumor emboli in the main trunk.
出处
《介入放射学杂志》
CSCD
2007年第8期560-562,共3页
Journal of Interventional Radiology
