進行肝細胞癌に対する反復化学動注療法:2種類の化学療法での比較・検討
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27 patients (Male: Female 26: 1) with advanced hepatocellular carcinoma were prescribed cyclic intra-arterial infusion chemotherapy via reservoir system from 1992 to 1996. Epirubicin (14 patients,20-50mg /body; Epi group) or Mitoxantrone (13 patients,6-8mg/body; Mito group) were administered 1 time during 4weeks. There was no significant difference in patient's characteristics between two treatment groups.23 patients had poor liver function (Child B and C), and 16 patients (8 patients in each groups) had portal vein thrombosis. To evaluate efficacy and disadvantage of two treatments, tomor response rate, patients' survival and complications were estimated.<BR>Tumor response rates were 35.7% and 30.7% in Epi group and Mito group respectively. Median survival periods were 11 and 9 months (N. S. ) for Epi group and Mito group respectively. In hepatocellular carcinoma of massive tomor type, survival period was prolonged in Mito group, and in patients with good liver function, survival period was prolonged in Epi group.<BR>One patients in Mito group developed Leucopenia. Liver damage and gastrointestinal damage that were complications due to regional arterial chemotherapy, were occurred in 8 patients (Epi group; 5cases, Mito group; 3cases). and 10 patients (6 cases: 4 cases). Arterial stenosis or obstruction were developed on each one of groups. The incidence of side effects was 57% for infusion chemotherapy of Epi, while 38%, relatively lower percentage, for infusion chemotherapy of Mito.<BR>These daga suggest that intra-arterial infusion chemotherapy using reservoir is effective for nodular type of advanced hapatocellular carcinoma without marked liver damage. Especially, in patient with good liver function, indication of Epirubicin is useful, and Mitoxantrone is administered for decreasing side effects and treatment of massive type.