Abstract:

Objective To evaluate the effectiveness of chemo-therapeutic drugs for Ⅲ and Ⅳ HB patients, constituded by in vitro adenosine triphosphate tumor chemosensitive assay(ATP-TCA) system. Methods Ⅲ and Ⅳ patients who received postoperative chemotherapy were selected in our department from June 2013 to June 2016, and divided into ATP-TCA group and control group according to if they had received ATP-TCA. ATP-TCA system was applied to test efficacies of Irinotecan(CPT-11), cisplatin (DDP)，vindesine (VDS), cyclophosphamide（CTX），pirarubicin（THP），etoposide (VP-16), paclitaxel （PTX）and 5-fluorouracil (5-FU), then the patients received precision chemotherapy according to ATP-TCA. Results The ATP-TCA group had 38 samples，2 of them quit the group because of fewer cells .2 of them had two surgeries and had two assay results. The control group had 40 samples. In the 38 samples,the sensitive rates were 84.2%to DDP, 78.9% to CPT-11, 78.9% to VDS,77.8% to CTX, 76.3% to 5-FU, 57.9% to THP, 47.3% to VP-16, 42.1% to PTX,respectively. In stage Ⅲ patients, no significant differences were found in mortality between ATP-TCA group and control group (15.4% vs 28.5%，P=0.077. In stage Ⅳpatients, significant differences were found in mortality between ATP-TCA group and control group(47.8% vs 61.5%，P=0.005）. In clinical trail,at the research end-point, significant differences were found in mortality between ATP-TCA group and control group(36.1% vs 50%，P=0.048. Conclusion The highest sensitivity drug was DDP. In ATP-TCA group, three-year survival rate was higher than control group, ATP-TCA system might be useful in evaluating the efficacy of drugs on HB samlpes, and in planning ivdividualized chemotherapy regimen for HB samples,and in planning individualized chemotherapy regimen for HB patients. ATP-TCA-guided chemotherapy might prolong survival time of HB patients.