| ObjectiveLiver cancer is the most common malignant tumor,the incidence of liver cancer in China has been ranked the top three cancer incidence. Mortality accounted for the first three tumor-related mortality.The treatment of tumors confined to the liver means which including surgery (resection or liver transplantation), local intervention (embolization, selective internal radiation therapy), and local ablation therapy(radiofrequency ablation, percutaneous ethanol injection) radiotherapy.However, the local treatment of surgery and the consequences of recurrence is high, there was infiltration of lesion type or lesion expansion type, or extrahepatic metastatic disease,or portal vein thrombosis, unfit to continue local treatment. Liver of most traditional systemic chemotherapy sensitivity is not high, objective response rate is generally low, and there is cytotoxicity.So now need a new targeted therapy of liver toxicity which is not clear, well-tolerated biological agents.In recent years, liver cancer as a high density of tumor blood vessels, the research on angiogenesis has attracted increasing attention. Antiangiogenic therapy can repair the abnormal blood vessels before tumor regression vascular system, so that the normalization of tumor blood vessels tend to more effectively transport oxygen and drugs to tumor cells, increased sensitivity to radiotherapy and chemotherapy. Treatment of tumor blood circulation to clear the blood vessels, increase blood supply, repair of vascular endothelial cell damage and inhibit their proliferation, vascular normalization may improve tissue ischemia and hypoxia, "blood stasis"state, and elimination of tumor angiogenesis Conditions.Therefore, The topic under the "tumor vascular normalization"theory, to be applied employing endostatin injection (ex degrees) and the blood circulation antineoplastic agents (elemene) patients with advanced liver cancer, blocking vascular endothelial growth factor or signaling pathway , exogenous angiogenesis inhibitors, so that gradual apoptosis of tumor microvascular abnormalities, neovascularization normalization of liver blood vessel wall to improve the structure, the ability to resist the invasion of hepatoma cells, but also can strengthen the role of radiotherapy and chemotherapy ,.Observe the biochemical indices and survival time, and analyze the factors affecting prognosis.Methods and Results36 cases were received previous surgery and/or topical treatment, but tumor recur rence and/or transfer of advanced liver cancer patients, 16 patients were randomly divided into treatment group and control group 20 patients.The treatment group Endotar injection with 7.5 mg/㎡/d, in 0.9% saline 500 ml diluted, slow intravenous infusion for 14 days for a period of rest after a week, recycling every two weeks of evaluation an effect. Infusion time to focus on blood pressure, heart rate and respiration changes, parallel ECG.Eiemene injection 400mg/times/day, diluted in 5% glucose injection250ml diluted slowly drip.14days for a course.The control group cinobufacini injection30ml /times/day,5% glucose injection 250ml diluted slowly drip, 14 days for a course.Before and after treatment by hand fill in the CRF for each scale, and make a telephone follow-up.The survival was defined as by surgery or/and local recurrence after treatment and/or transfer time to death or last follow-up information of the time, in months for the unit.Results:in the blood, liver and kidney function, and alpha-fetoprotein measurement and other laboratory tests, the two groups before and after treatment no difference between the two groups (p>0.05). Experimental group average survival time (7.50±5.57) months in the control group average survival time (4.05±2.01)months.The survival time as the abscissa, the survival rate for the vertical axis depicts the survival curve in both groups.Log-rank test method used, the survival curves of the two groups was statistically significant difference p <0.01), suggest a poor prognosis in patients with the control group.To survival time as the dependent variable, age (>50 years and≤50 years), cirrhosis (decompensated and compensated), hepatitis B history (and Without), AFP (≥400ug/ml;less than 400ug/ml) as prognostic factors and the as signment.Multivariate Cox regression analysis, p>0.05, indicating that these independent prognostic factors can not affect the survival time of patients with advanced hepatocellular carcinoma. ConclusionIn this study, anti-angiogenic drugs-En joint degree program elemene treatment has been surgery and/or local treatment and still transfer and / or recurrence in patients with advanced liver cancer, compared with the control group to extend its lifetime.And clinical application security, the majority had no significant side effects.But Endostar combined Elemene treatment options of patients did not improve in the test laboratory indicators; which also failed to find that can affect the survival time of patients with advanced hepatocellular carcinoma prognostic factors. |
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