Most of all commonly used chemotherapy drugs were tested in liver cancer treatment, but much more efficient 10% -15% in the following. Systemic chemotherapy alone has not in favor of applications, and is mainly used for regional exploration of chemotherapy and combined therapy. Has some effect on liver cancer and liver cancer chemotherapy drugs commonly used in the following categories:
Liver cancer chemotherapy drug commonly used (a) adriamycin (ADM) and its derivatives
ADM for the benefit wine antibiotics, mainly through the inhibition of DAN into the DNA template replication. ADM was considered to be the most effective chemotherapy treatment of liver cancer drugs, treatment, remission rates of liver cancer is slightly superior than other chemotherapy drugs, is currently one of the drugs commonly used in treatment of liver cancer. ADM cardiac toxicity of chemotherapy drugs in the most serious, can cause premature, 5T-T changes, delayed myocardial damage, and even lead to irreversible heart failure. AD lifetime cumulative dose should be controlled within the 500-550mg/m2 generally not serious heart damage. For over 70 years old, the original heart disease, had used high-dose CTX, had the line mediastinal radiotherapy, ADM's total should be <450mg/m2.
ADM Derivatives are commonly used in liver cancer M IT, E-ADM, pirarubicin (THP) and so on. MIT's cardiac toxicity was mild compared with ADM, has been reported by MIT hepatic artery infusion can reduce the tendency of high recurrence rate of hepatocellular carcinoma recurrence. E-ADM ADM cardiac toxicity is only 50% of bone marrow toxicity of 70% for the ADM. TACE has been reported in the application of E-ADM and ADM similar effect, but also reported that E-ADM is better than ADM. E-ADM cumulative dose should not exceed 700 – 800mg / m2. ADM THP cardiac toxicity than light in recent years, many applications THP chemoembolization treatment of liver cancer reported, but the effect is better than ADM, EADM remains to be seen.
Liver cancer chemotherapy drug commonly used in (b) mitomycin C (MMC) and other
MMC in vivo role of hepatic drug metabolizing enzyme, reducing agent for the bifunctional melted, and DNA cross-link formation, inhibit DNA synthesis. MMC has been widely used in various gastrointestinal tumors, especially highly respected in Japan. In recent years, found that etoposide) for the semi-synthetic derivatives of podophyllotoxin one drug, by inhibiting DNA topoisomerase play a role in cancer, lung cancer, malignant lymphoma, gastrointestinal cancer, ovarian cancer, and so have a certain effect. Some academics have also be used in combination chemotherapy of liver cancer in 1997, Bobbio-pallavivini VP-16 combined with other E-ADM 36 Patients with liver cancer, 39% efficient, with a median survival of 10 months. VP-16 in liver cancer is rarely applied, its efficacy remains to be more clinical validation. Porcelain camptothecin (HCPT) for the domestic synthetic drug, to DNA topoisomerase I inhibitor, local chemotherapy in liver cancer is also common, but its efficacy has yet to be confirmed.
Liver cancer chemotherapy drug commonly used in (c) cisplatin and uranium (DDP) and its derivatives
DDP mechanism of action similar to melted agent, causing DNA cross-linking, interference with normal cell division and work. DDP broad spectrum anti-tumor, anti-cancer effect of strong, have good effect on a variety of tumors. DDP treatment of liver cancer also have some effect, for the present liver local chemotherapy, chemoembolization is one of the commonly used drugs. Kasugai, etc. has compared the DDP and MMC chemotherapy embolization embolization chemotherapy, and found that the effect of DDP was better than MMC. In addition, DDP for 5-FU with biochemical modulation, the two combined synergistic effect, in recent years some scholars have combined with DDP 5-FU hepatic arterial infusion method of treatment of recurrent liver cancer, liver cancer with portal vein tumor thrombus, the Invalid liver embolization, achieving a more substantial effect, it is worth further study.
DDP toxicities mainly as gastrointestinal reactions and renal toxicity, can cause kidney distal tubule degeneration and necrosis, hyaline degeneration of proximal convoluted tubules, or even irreversible renal failure. Intravenous application of a one-time dose of more than 60mg should be fully hydrated to reduce its damage to the kidneys, topical application can reduce the toxicity. To reduce the toxicity of DDP, lead classes in recent years a number of complex synthesis, the main lead in the second generation of cards (CBP) and the third generation of oxalic acid sales (L-OHP). CBP on a variety of tumors, significantly reduced renal toxicity than DDP, but bone marrow suppression was more apparent. L-OH of the lower renal toxicity, but has some nerve toxicity. L-OHP in the treatment of gastrointestinal cancer achieved good effect, but in the treatment of liver cancer remains to be seen whether the DDP is superior.