摘要目的 探讨三氧化二砷(As2O3)联合动脉化疗栓塞对原发性肝癌肺转移患者的治疗效果.方法 60例原发性肝癌肺转移患者随机分为A、B两组.A组为治疗组,共30例患者,对肝脏原发病灶行周期性肝动脉化疗栓塞术(TACE),TACE后3d开始给予As2O3持续静脉滴注5h(10 mg/d,14 d为1个疗程),间隔2周,连续进行3～4个周期；B组为对照组,共30例患者,对肝脏原发病灶行周期性TACE.观察两组患者的客观有效率、获益率、生活质量等指标及转移瘤大小、灶数与疗效的相关性.结果 A组患者中客观有效率为26.7％ (8/30),获益率60.0％ (18/30),B组客观有效率为0,获益率16.7％ (5/30),两组客观有效率及获益率的差异均具有统计学意义(x2=7.067,P=0.008;x2=11.915,P=0.001).A组患者中生活质量改善4例,稳定18例,B组患者中改善0例,稳定13例,两组差异有统计学意义(x2=9.669,P=0.008).肿瘤负荷与疗效呈显著负相关,且相关关系密切(Kendall相关系数为-0.765,P＜0.001；Spearman相关系数为-0.821,P＜0.001).结论 As2O3联合动脉化疗栓塞是一种治疗原发性肝癌肺转移的有效治疗方法.

abstractsObjective To observe the therapeutic effects of arsenic trioxide combined with transcatheter arterial chemoembolization on treatment of primary liver cancer with pulmonary metastases.Methods Sixty patients were randomly divided into two groups:group A (treatment group,n =30) and group B (control group,n =30).Group A was received periodic transcatheter arterial chemoembolization (TACE) and 10 mg arsenic trioxide by intravenous infusion for 5 hours per day,3 days after TACE.Each cycle consisted of 14 days' administration,and repeated after 2 weeks.Each patient was received 3-4 successive cycles.Group B was received periodic TACE alone.Objective efficiency,benefit rate,quality of life and the correlates with metastatic tumor size and number in the both groups were recorded.Results The objective efficiency was 26.7％ (8/30),and the benefit rate was 60.0％ (18/30) in group A,while they were 0 and 16.7％ (5/30) in group B with significant statistics differences (x2 =7.067,P =0.008;x2 =11.915,P =0.001).The quality of life was improved in 4 patients and stable in 18 of group A,while no patient was improved and 13 were stable in group B (x2 =9.669,P =0.008).There was a significantly positive correlation between the tumor burden and therapeutic effect (Kendall r =-0.765,P ＜ 0.001 ;Spearman r =-0.821,P ＜ 0.001).Conclusion Arsenic trioxide combined TACE is an effective treatment method in treating primary liver cancer with pulmonary metastases.