Title

體外化療藥物敏感實驗對指導原發性肝癌個體化療的臨床意義

Translated Titles

Application of Adenosine Triphosphate Tumor Chemosensitive Assay System to Individual Chemotherapy for Hepatocellular Carcinoma

Authors

陳濤(Tao Chen);楮忠華(Zhong-Hua Chu);劉建平(Jian-Ping Liu);王捷(Jie Wang);趙海燕(Hai-Yan Zhao);区慶嘉(Qing-Jia Ou)

Key Words

肝腫瘤 ; 癌,肝細胞 ; 體外藥敏實驗 ; 藥物療法 ; 個體化治療 ; Liver neoplasms ; Carcinoma, liver cells ; In vitro chemo-drug sensitive test ; Drug therapy ; Individual treatment

PublicationName

癌症

Volume or Term/Year and Month of Publication

24卷8期(2005 / 08 / 05)

Page #

1018 - 1022

Content Language

簡體中文

Chinese Abstract

背景與目的:肝細胞癌(肝癌)化學治療效果差。為了提高化療效果,本研究採用體外化療敏感實驗―三磷酸腺苷腫瘤化療藥物敏感實驗(adenosine triphosphate tumor chemosensitivity assay,ATP-TCA)系統評估化療藥物,並利用該系統指導肝癌患者臨床個體化療。方法:獲取50個原發性肝癌手術標本,採用ATP-TCA系統評估5-氟尿嘧啶(5-fluorouracil,5-FU)、絲裂黴素(mitomycin,MMC)、順鉑(cisplatin,DDP)、草酸鉑(oxaliplatin,OXA)、表阿黴素(epirubicin,EPI)、健擇(gemcitabine,GEM)、伊立替康(irinotecan,CFT-11)、足葉乙甙(etoposide,VP-16)和泰素(paclitaxel,PTX)等化療藥物;23例肝癌患者術後接受ATP-TCA系統指導臨床化療,同時以20例接受手術及常規治療的肝癌患者作為對照,觀察162周臨床療效。結果:ATP-TCA系統結果可評估率為90.8%。肝癌細胞對各種化療藥物中-高度敏感率分別為:泰素46%、伊立替康44%、健擇36%、絲裂黴素14%、表阿黴素12%、順鉑8%、足葉乙甙6%、草酸鉑6%以及5-氟尿嘧啶4%;臨床結果:臨床研究觀察終點ATP-TCA組與對照組比較,PR、CR、SD及觀察期內患者死亡率兩組之間無顯著性差異;然而對照組有較高病情進展發生率(60.00% vs. 13.04%,P=0.003);ATP-TCA組較對照組在總病情緩解率(60.86% vs. 30.00%,P=0.043)、平均手術後總生存期(78.91周vs. 27.21周,P=0.006)及手術後無疾病進展生存期(30.52周vs. 4.78周,P=0.005)方面表現出明顯優勢。結論:ATP-TCA系統可以成功用於評估肝癌標本。泰素、伊立替康和健擇有較高的體外抗肝癌活性。ATP-TCA系統指導肝癌個體化療有可能提高患者無疾病進展生存期和總生存期。

English Abstract

Background & Objective: Present chemotherapy for hepatocellular carcinoma (HCC) is not effective. To improve the effect of chemotherapy, in vitro chemo-drug sensitive testing system, adenosine triphosphate tumor chemosensitive assay (ATP-TCA) system, was used to evaluate efficacies of chemotherapeutic drugs, and to guide clinical individual chemotherapy for HCC patients. Methods: ATP-TCA system was applied to test efficacies of 5-fluorouracil (5-FU), mitomycin (MMC), cisplatin (DDP), oxaliplatin (OXA), epirubicin (EPI), gemcitabine (GEM), irinotecan (CPT-11), etoposide (VP-16), and paclitaxel (PTX) on 50 HCC samples. Twenty- three HCC patients received ATP-TCA-directed chemotherapy (ATP-TCA group); 20 HCC patients received surgery and routine treatments (control group). Clinical outcomes of these patients were observed for 162 weeks. Results: The assessable rate of ATP-TCA result is 90.8%. In the 50 samples, the sensitive (moderate to high degree) rates were 46% to PTX, 44% to CPT-11, 36% to GEM, 14% to MMC, 12% to EPI, 8% to DDP, 6% to VP-16, 6% to OXA, and 4% to 5-FU, respectively. In clinical trial, at the research end-point, no significant differences were found in partial remission (PR), complete remission (CR), stable disease (SD), and mortality between ATP-TCA group and control group (P>0.05), but progression disease (PD) rate was significantly higher in control group than in ATP-TCA group (60.00% vs.13.04%, P=0.003); significant differences were found in overall response rate (ORR) (60.86% vs. 30.00%, P=0.043), overall survival (OS) (78.91 weeks vs. 27.21 weeks, P=0.006), and progress-free survival (PFS) (30.52 weeks vs. 4.78 weeks, P=0.005) between ATP-TCA group and control group. Conclusions: ATP-TCA system might be useful in evaluating the efficacy of chemotherapeutic drugs on HCC samples, and in planning individualized chemotherapy regimen for HCC patients. PTX, OPT-11 and GEM might be potential drugs for the treatment of HCC. ATP-TCA-guided chemotherapy might prolong survival time of HCC patients.

Topic Category 醫藥衛生 > 內科