静脉化疗联合PEI治疗乳腺癌术后肝转移15例疗效观察.pdf

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1、蚌埠医学院学报2013年10月笈38卷箜1263[文章编号]1000—2200(2013)10—1263—03·临床医学·静脉化疗联合PEI治疗乳腺癌术后肝转移15例疗效观察谢广龙，黄柱华，周争光，蒲春华，周海荣，刘新群[摘要]目的：观察静脉化疗联合经皮穿刺无水乙醇瘤内注射(PEI)治疗乳腺癌伴肝转移的疗效。方法：15例均为乳腺癌术后并确诊有肝转移，给予化疗(TP方案)：紫杉醇135mg／m，第1天，静脉输注；顺铂40mg／d，第2～4天，静脉输注。28d为1周期，均用4疗程以上。同时化疗前、后肝转移瘤灶给予彩超引导下PEI治疗，每个病灶最少2次，最多4次。结果：完全缓解3例，部分缓解12例，

2、有效率100％；均存活6个月以上，l0例病死患者中最长存活22个月。不良反应为食欲低下、恶心呕吐、白细胞减少、肝功能一过性异常和穿刺部位疼痛。结论：PET和TP方案静脉全身化疗对乳腺癌术后肝转移有一定疗效。[关键词]乳腺肿瘤；肝转移；无水乙醇；穿刺术[中国图书资料分类法分类号]R737．9[文献标志码]AClinicalobservationofsystemicchemotherapycombinedwithpercutaneousethanolinjectiontreatmentonbreastcarcinomapostoperationwithlivermetastasisXIEGuang

3、．1ong，HUANGZhu—hua，ZHOUZheng—guang，PUChun—hua，ZHOUHai—rong，LIUXin—qun(J．DepartmentofFunctional，2．DepartmentofMedicalOncology，ThefAfiliatedHospitalofBengbuMedicalCollege，BengbuAnhui233004，China)[Abstract]Objective：Toexploretheefficacyofsystemicchemotherapycombinedwithpereutaneousethanolinjection(PEI)

4、treatmentonbreastcarcinomapostoperativepatientswithlivermetastasis．Methods：Fifteencaseswereallbreastcancerpostoperativepatientswithlivermetastasis．Allpatientswerereceivedpaclitaxeltoisplatin(TP)protoco1．Thetreatmentincludedsystemicchemotherapyofpaclitaxel135mg／mintravenousinjectiononfirstdayfollowed

5、bycisplatin30mg／dfor3days，28daysforonecycle，andeachpatientwasexperiencedformorethan4courses．MetastatictumorfociofliverwasalsoreceivedtherapyofPEIunderultrasound—guided．Eachlociwasexperiencedtreatmentfor2to4times．Results：Threeeaseswerecompleteremission，12caseswerepartialremission，thetotalresponserate

6、was100％．Allpatientssurvivedformorethan6months，in10casesofdeath，onepatientsurvivedfor22months．Adversereactionincludedlowerappetite，nausea，voiniting，neutropenia，transientliverfunctionabnormalitiesandthepuncturesitepain．Conclusions：ThecombinationofPETandsystemicchemotherapybyTPprotocolmaybeaneffectivet

7、reatmenttopostoperativepatientswithbreastcarcinomaandhepaticmetastasis．[Keywords]breastneoplasms；livermetastasis；ethanol；pereutaneousinjection恶性肿瘤易发生血行转移至肝脏，甚至在首诊要的因素，临床处理棘手且预后差J。原发性肝癌时就发现肝脏有转移，肝转移多发生