TACE联合替吉奥治疗原发性肝癌的近期疗效、毒副作用及生存情况观察
|
摘要
目的研究应用肝动脉化疗栓塞(TACE)联合替吉奥治疗对原发性肝癌的近期疗效、毒副作用及生存时间的影响。方法选择2013年2月~2014年1月崇左市人民医院收治的原发性肝癌患者50例按照随机数字表法分为两组,每组各25例。单纯治疗组患者接受TACE治疗,联合治疗组患者在TACE治疗的基础上应用替吉奥治疗。比较两组近期疗效、毒副作用发生情况、3年内生存情况及生存质量。结果联合治疗组的近期疗效有效率,1、2、3年生存率及生存时间分别为84.00%、84.00%、68.00%、44.00%、(17.63±1.85)个月,明显高于单纯治疗组的56.00%、52.00%、32.00%、16.00%、(10.52±1.74)个月,差异有统计学意义(P<0.05或P<0.01);联合治疗组的总毒副作用发生率为4.00%,明显低于单纯治疗组的40.00%,差异有高度统计学意义(P<0.01);联合治疗组各项生存质量评分明显高于单纯治疗组,差异有高度统计学意义(P<0.01)。结论应用TACE联合替吉奥对原发性肝癌患者治疗,可显著提高近期疗效,减少毒副作用,延长生存时间,提高生存质量,可进一步推广。
Objective To study the influence of short-term efficacy, toxic side effects and survival time of TACE combined with oral Tegafur Gimeracil Oteracil Potassium on treatment of primary hepatic carcinoma. Methods From February 2013 to January 2014, in Chongzuo People's Hospital, 50 patients with primary hepatic carcinoma admitted into the hospital were divided into two groups by random number table, with 25 cases in each group. Simple treatment group was given TACE, and association group was given Tegafur Gimeracil Oteracil Potassium on the basis of treatment of simple treatment group. Patients of two groups were given follow-up investigation, and short-term efficacy, toxic side effects, survival situation within 3 years and survival quality of two groups were compared. Results The short-term effective rate, survival rate of 1, 2, 3 years and survival time of association group were 84.00%, 84.00%, 68.00%, 44.00%,(17.63±1.85) months, which were significantly higher than 56.00%, 52.00%, 32.00%, 16.00%,(10.52±1.74) months of simple treatment group(P < 0.05 or P < 0.01); the total incidence of toxic side effects in association group was 4.00%, which was significantly lower than 40.00% in simple treatment group, and there was statistical difference(P < 0.01); the scores of each survival quality of association group were significantly higher than those of simple treatment group, and there were statistical difference(P < 0.01). Conclusion TACE combined with oral Tegafur Gimeracil Oteracil Potassium in treatment of patients with primary hepatic carcinoma can significantly increase short-term efficacy, reduce toxic side effects,lengthen survival time and improve survival quality, which is worthy of further promotion.
Objective To study the influence of short-term efficacy, toxic side effects and survival time of TACE combined with oral Tegafur Gimeracil Oteracil Potassium on treatment of primary hepatic carcinoma. Methods From February 2013 to January 2014, in Chongzuo People's Hospital, 50 patients with primary hepatic carcinoma admitted into the hospital were divided into two groups by random number table, with 25 cases in each group. Simple treatment group was given TACE, and association group was given Tegafur Gimeracil Oteracil Potassium on the basis of treatment of simple treatment group. Patients of two groups were given follow-up investigation, and short-term efficacy, toxic side effects, survival situation within 3 years and survival quality of two groups were compared. Results The short-term effective rate, survival rate of 1, 2, 3 years and survival time of association group were 84.00%, 84.00%, 68.00%, 44.00%,(17.63±1.85) months, which were significantly higher than 56.00%, 52.00%, 32.00%, 16.00%,(10.52±1.74) months of simple treatment group(P < 0.05 or P < 0.01); the total incidence of toxic side effects in association group was 4.00%, which was significantly lower than 40.00% in simple treatment group, and there was statistical difference(P < 0.01); the scores of each survival quality of association group were significantly higher than those of simple treatment group, and there were statistical difference(P < 0.01). Conclusion TACE combined with oral Tegafur Gimeracil Oteracil Potassium in treatment of patients with primary hepatic carcinoma can significantly increase short-term efficacy, reduce toxic side effects,lengthen survival time and improve survival quality, which is worthy of further promotion.
引文
[1]胡鸿涛,陈呈世,黎海亮,等.三氧化二砷联合索拉非尼及肝动脉化疗栓塞治疗难治性肝细胞癌肺转移[J].中华肿瘤杂志,2015,37(12):942-943.
[2]董安楠,李旺,吴方明,等.细胞因子诱导杀伤细胞免疫联合微创介入治疗早期肝癌的长期临床疗效观察[J].中华医学杂志,2015,95(33):2668-2672.
[3]Salsamendi J,Pereira K,Kang K,et al.Minimally invasive percutaneous endovascular therapies in the management of complications of non-alcoholic fatty liver disease(NAFLD):A case report[J].J Radiol Case Rep,2015,9(9):36-43.
[4]曾昭吝,刘雪莲,黄文薮,等.肝细胞癌肝动脉化疗栓塞术后胆汁瘤形成的危险因素及临床特点分析[J].中华医学杂志,2015,95(13):1002-1005.
[5]中国抗癌协会肝癌专业委员会.原发性肝癌的临床诊断与分期标准[J].中华肝脏病杂志,2001,9(26):324.
[6]Tang YL,Qi XS,Guo XZ,et al.Hepatic Resection after Initial Transarterial chemoembolization versus transarterial chemoembolization alone for the treatment of hepatocellular carcinoma:a Meta-analysis of observational studies[J].Asian Pac J Cancer Prev,2015,16(17):7871-7874.
[7]唐哲,万仁瑞,胡洪涛,等.吲哚菁绿实验对巴塞罗那B/C期肝癌患者行经导管动脉化疗栓塞术治疗的风险评估[J].中华实验外科杂志,2015,32(10):2365-2367.
[8]谭凯,杜锡林,杨涛,等.手术切除、肝动脉化疗栓塞、微波固化联合门静脉化疗对肝细胞癌术后复发的疗效分析[J].中华肝胆外科杂志,2014,20(4):253-257.
[9]Yuan GS,Zhou YC,Zhang H,et al.Baseline quantitative hepatitis B core antibody could strongly predict survival for patients with hepatocellular carcinoma undergoing transarterial chemoembolization[J].Int J Clin Exp Med,2015,8(8):13524-13531.
[10]罗家敏,罗小平,刘曦,等.右肾包膜动脉参与供血的原发性肝癌患者的影像表现及经导管动脉化疗栓塞治疗[J].中华肝脏病杂志,2015,23(7):517-521.
[11]芦东徽,唐隽,周俊平,等.三维适形放射治疗联合经皮肝动脉化疗栓塞不同序贯顺序治疗原发性肝癌伴门静脉癌栓的临床对照[J].中华肝脏病杂志,2015,23(3):184-188.
[12]王振军,黎海亮,郭晨阳,等.肝动脉化疗栓塞联合FOLFOX方案动脉留管灌注治疗BCLC-B期原发性肝癌疗效观察[J].中华实用诊断与治疗杂志,2015,29(10):1031-1033.
[13]Cascales-Campos PA,Ramírez P,Lopez V,et al.Prognostic value of 18-Fluorodeoxyglucose-positron emission tomography after transarterial chemoembolization in patients with hepatocellular carcinoma undergoing orthotopic liver transplantation[J].Transplant Proc,2015,47(8):2374-2376.
[14]杨学刚,周石,文华长,等.乙型肝炎相关肝细胞肝癌肝动脉灌注化疗栓塞前中性粒细胞与淋巴细胞比值与患者预后的相关性[J].中华放射学杂志,2015,49(10):769-773.
[15]Li Q,Ao GK,Duan F,et al.Incidence and therapeutic frequency of extrahepatic collateral arteries in transcatheter arterial chemoembolization of hepatocellular carcinoma:experience from 182 patients with survival time more than 3 years[J].Eur J Radiol,2015,84(12):2555-2563.
[16]张健,龚少娟,宋卫华,等.肝动脉化疗TACE联合3DCRT治疗HCC伴PVTT患者的疗效[J].浙江临床医学,2016,18(12):2191-2192,2195.
[17]Du FZ,Jiang R,Gu M,et al.The clinical application of320-detector row CT in transcatheter arterial chemoembolization(TACE)for hepatocellular carcinoma[J].Radiol Med,2015,120(8):690-694.
[18]吕江,陈茂恩,李冲,等.原发性肝癌肝外侧支血供动脉的特点和介入治疗分析[J].癌症进展,2016,14(7):703-705.
[19]李彬,孙超,段惠勇,等.经肝动脉化疗栓塞术联合冷循环微波刀治疗肝癌的临床研究[J].中国医学装备,2015,12(12):137-139.
[20]王海存,王萌萌,曹旸,等.肝动脉化疗栓塞术后应用奥沙利铂联合替吉奥治疗晚期原发性肝癌的临床观察[J].中国药房,2017,28(11):1555-1558.
[21]牛楠,刘佳,吴荣,等.奥沙利铂联合替吉奥二线治疗晚期胆囊癌的临床效果[J].中国医药导报,2016,13(18):142-145.
[22]鲁磊,叶新平.手术切除联合术后肝动脉化疗栓塞术治疗原发性肝细胞癌的临床效果[J].中国医药,2016,11(12):1790-1794.
[23]Yamamoto T,Miyazaki T,Kurashima Y,et al.A Case report of successful chemotherapy with tegafur/gimeracil/oteracil and Nab-Paclitaxel for gastric cancer with chronic renal failure[J].Gan To Kagaku Ryoho,2015,42(6):735-738.
[2]董安楠,李旺,吴方明,等.细胞因子诱导杀伤细胞免疫联合微创介入治疗早期肝癌的长期临床疗效观察[J].中华医学杂志,2015,95(33):2668-2672.
[3]Salsamendi J,Pereira K,Kang K,et al.Minimally invasive percutaneous endovascular therapies in the management of complications of non-alcoholic fatty liver disease(NAFLD):A case report[J].J Radiol Case Rep,2015,9(9):36-43.
[4]曾昭吝,刘雪莲,黄文薮,等.肝细胞癌肝动脉化疗栓塞术后胆汁瘤形成的危险因素及临床特点分析[J].中华医学杂志,2015,95(13):1002-1005.
[5]中国抗癌协会肝癌专业委员会.原发性肝癌的临床诊断与分期标准[J].中华肝脏病杂志,2001,9(26):324.
[6]Tang YL,Qi XS,Guo XZ,et al.Hepatic Resection after Initial Transarterial chemoembolization versus transarterial chemoembolization alone for the treatment of hepatocellular carcinoma:a Meta-analysis of observational studies[J].Asian Pac J Cancer Prev,2015,16(17):7871-7874.
[7]唐哲,万仁瑞,胡洪涛,等.吲哚菁绿实验对巴塞罗那B/C期肝癌患者行经导管动脉化疗栓塞术治疗的风险评估[J].中华实验外科杂志,2015,32(10):2365-2367.
[8]谭凯,杜锡林,杨涛,等.手术切除、肝动脉化疗栓塞、微波固化联合门静脉化疗对肝细胞癌术后复发的疗效分析[J].中华肝胆外科杂志,2014,20(4):253-257.
[9]Yuan GS,Zhou YC,Zhang H,et al.Baseline quantitative hepatitis B core antibody could strongly predict survival for patients with hepatocellular carcinoma undergoing transarterial chemoembolization[J].Int J Clin Exp Med,2015,8(8):13524-13531.
[10]罗家敏,罗小平,刘曦,等.右肾包膜动脉参与供血的原发性肝癌患者的影像表现及经导管动脉化疗栓塞治疗[J].中华肝脏病杂志,2015,23(7):517-521.
[11]芦东徽,唐隽,周俊平,等.三维适形放射治疗联合经皮肝动脉化疗栓塞不同序贯顺序治疗原发性肝癌伴门静脉癌栓的临床对照[J].中华肝脏病杂志,2015,23(3):184-188.
[12]王振军,黎海亮,郭晨阳,等.肝动脉化疗栓塞联合FOLFOX方案动脉留管灌注治疗BCLC-B期原发性肝癌疗效观察[J].中华实用诊断与治疗杂志,2015,29(10):1031-1033.
[13]Cascales-Campos PA,Ramírez P,Lopez V,et al.Prognostic value of 18-Fluorodeoxyglucose-positron emission tomography after transarterial chemoembolization in patients with hepatocellular carcinoma undergoing orthotopic liver transplantation[J].Transplant Proc,2015,47(8):2374-2376.
[14]杨学刚,周石,文华长,等.乙型肝炎相关肝细胞肝癌肝动脉灌注化疗栓塞前中性粒细胞与淋巴细胞比值与患者预后的相关性[J].中华放射学杂志,2015,49(10):769-773.
[15]Li Q,Ao GK,Duan F,et al.Incidence and therapeutic frequency of extrahepatic collateral arteries in transcatheter arterial chemoembolization of hepatocellular carcinoma:experience from 182 patients with survival time more than 3 years[J].Eur J Radiol,2015,84(12):2555-2563.
[16]张健,龚少娟,宋卫华,等.肝动脉化疗TACE联合3DCRT治疗HCC伴PVTT患者的疗效[J].浙江临床医学,2016,18(12):2191-2192,2195.
[17]Du FZ,Jiang R,Gu M,et al.The clinical application of320-detector row CT in transcatheter arterial chemoembolization(TACE)for hepatocellular carcinoma[J].Radiol Med,2015,120(8):690-694.
[18]吕江,陈茂恩,李冲,等.原发性肝癌肝外侧支血供动脉的特点和介入治疗分析[J].癌症进展,2016,14(7):703-705.
[19]李彬,孙超,段惠勇,等.经肝动脉化疗栓塞术联合冷循环微波刀治疗肝癌的临床研究[J].中国医学装备,2015,12(12):137-139.
[20]王海存,王萌萌,曹旸,等.肝动脉化疗栓塞术后应用奥沙利铂联合替吉奥治疗晚期原发性肝癌的临床观察[J].中国药房,2017,28(11):1555-1558.
[21]牛楠,刘佳,吴荣,等.奥沙利铂联合替吉奥二线治疗晚期胆囊癌的临床效果[J].中国医药导报,2016,13(18):142-145.
[22]鲁磊,叶新平.手术切除联合术后肝动脉化疗栓塞术治疗原发性肝细胞癌的临床效果[J].中国医药,2016,11(12):1790-1794.
[23]Yamamoto T,Miyazaki T,Kurashima Y,et al.A Case report of successful chemotherapy with tegafur/gimeracil/oteracil and Nab-Paclitaxel for gastric cancer with chronic renal failure[J].Gan To Kagaku Ryoho,2015,42(6):735-738.