奥沙利铂联合表柔比星介入治疗原发性肝癌的临床效果分析
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摘要
目的探讨奥沙利铂联合表柔比星介入治疗原发性肝癌的临床效果。方法选择2016年2月—2018年10月在河南省郑州市第十六人民医院收治的64例原发性肝癌(PLC)患者为研究对象,将患者以随机数字表法分为A组(n=32)和B组(n=32),两组患者均接受经导管肝动脉化疗栓塞术(TACE),其中A组患者作为观察组采用奥沙利铂联合表柔比星作为治疗方案,B组患者采用奥沙利铂联合吉西他滨灌注治疗作为对照组,对比分析两组患者治疗后总缓解率、AFP及生存率等情况。结果治疗前A组患者血清甲胎蛋白(233.05±12.64)ng/mL,B组患者血清甲胎蛋白(233.14±13.14)ng/mL,差异无统计学意义(P>0.05);治疗后A组患者血清甲胎蛋白(119.25±4.26)ng/mL,B组患者血清甲胎蛋白(202.35±4.26)ng/mL,差异有统计学意义(P<0.05);治疗后A组患者CR 15例、PR 13例,OR率87.5%,B组患者CR 5例、PR 12例,OR率53.1%,差异有统计学意义(P<0.05);A组患者治疗后恶心呕吐3例、血小板减少1例、白细胞降低1例,总发生率15.6%,B组患者治疗后恶心呕吐2例、血小板减少3例、白细胞降低3例、末梢神经感觉异常1例,总发生率25.0%,差异有统计学意义(P<0.05);A组患者6个月存活率93.8%、1年存活率68.6%,B组患者6个月存活率68.6%、1年存活率40.6%,差异有统计学意义(P<0.05)。结论原发性肝癌(PLC)患者应用奥沙利铂联合表柔比星联合介入治疗可以显著降低AFP水平,提高患者近中期生存率,安全性较好。
Objective To investigate the clinical effects of oxaliplatin combined with epirubicin in the treatment of primary liver cancer. Methods 64 patients with primary hepatocellular carcinoma(PLC) admitted to Zhengzhou 16 th People's Hospital of Henan Province from February 2016 to October 2018 were selected as the subjects. The patients were randomly divided into the group A(n=32)and the group B(n=32). Both groups received transcatheter arterial chemoembolization(TACE). The group A was treated with oxaliplatin combined with epirubicin as the observation group. As a treatment plan, the group B was treated with oxaliplatin combined with gemcitabine perfusion as the control group. The total remission rate, AFP and survival rate after treatment were compared and analyzed between two groups. Results There was no significant difference in serum alpha-fetoprotein(233.05(+12.64) ng/mL) between the group A and the group B before treatment(233.14(+13.14) ng/mL)(P > 0.05); serum alpha-fetoprotein(119.25(+4.26) ng/mL) in the group A and alpha-fetoprotein(202.35(+4.26) ng/mL) in the group B after treatment(P < 0.05). 5 cases, 13 cases of PR, OR rate 87.5%, CR 5 cases, PR 12 cases, OR rate 53.1%, the difference was statistically significant(P < 0.05); 3 cases of nausea and vomiting, 1 case of thrombocytopenia and 1 case of leukopenia after treatment in the group A, the total incidence was 15.6%. 2 cases of nausea and vomiting,3 cases of thrombocytopenia, 3 cases of leukopenia and 1 case of peripheral neurosensory abnormality after treatment in the group B, the total incidence was 1 case. The 6-month survival rate of the group A was 93.8%, the 1-year survival rate was 68.6%, the 6-month survival rate of the group B was 68.6%, and the 1-year survival rate was 40.6%. The difference was statistically significant(P<0.05).Conclusion Oxaliplatin combined with epirubicin can significantly reduce the level of AFP in patients with primary hepatocellular carcinoma(PLC), improve the short-term and medium-term survival rate, and have better safety.
Objective To investigate the clinical effects of oxaliplatin combined with epirubicin in the treatment of primary liver cancer. Methods 64 patients with primary hepatocellular carcinoma(PLC) admitted to Zhengzhou 16 th People's Hospital of Henan Province from February 2016 to October 2018 were selected as the subjects. The patients were randomly divided into the group A(n=32)and the group B(n=32). Both groups received transcatheter arterial chemoembolization(TACE). The group A was treated with oxaliplatin combined with epirubicin as the observation group. As a treatment plan, the group B was treated with oxaliplatin combined with gemcitabine perfusion as the control group. The total remission rate, AFP and survival rate after treatment were compared and analyzed between two groups. Results There was no significant difference in serum alpha-fetoprotein(233.05(+12.64) ng/mL) between the group A and the group B before treatment(233.14(+13.14) ng/mL)(P > 0.05); serum alpha-fetoprotein(119.25(+4.26) ng/mL) in the group A and alpha-fetoprotein(202.35(+4.26) ng/mL) in the group B after treatment(P < 0.05). 5 cases, 13 cases of PR, OR rate 87.5%, CR 5 cases, PR 12 cases, OR rate 53.1%, the difference was statistically significant(P < 0.05); 3 cases of nausea and vomiting, 1 case of thrombocytopenia and 1 case of leukopenia after treatment in the group A, the total incidence was 15.6%. 2 cases of nausea and vomiting,3 cases of thrombocytopenia, 3 cases of leukopenia and 1 case of peripheral neurosensory abnormality after treatment in the group B, the total incidence was 1 case. The 6-month survival rate of the group A was 93.8%, the 1-year survival rate was 68.6%, the 6-month survival rate of the group B was 68.6%, and the 1-year survival rate was 40.6%. The difference was statistically significant(P<0.05).Conclusion Oxaliplatin combined with epirubicin can significantly reduce the level of AFP in patients with primary hepatocellular carcinoma(PLC), improve the short-term and medium-term survival rate, and have better safety.
引文
[1]罗轩明,赵晋明,白磊,李涛,曹俊,何翼彪,贺小龙,张金辉.原发性肝癌手术治疗的技术要点[J].新疆医学,2018,48(5):555-557+563.
[2]刘家贺,于全成.奥沙利铂联合表柔比星经导管肝动脉化疗栓塞介入治疗原发性肝癌临床分析[J].现代医药卫生,2014,30(5):743-744.
[3] Reni M, Balzano G, Aprile G, et al. Adjuvant PEFG(cisplatin, epirubicin, 5-fluorouracil, gemcitabine)or gemcitabine followed by chemoradiation in pancreatic cancer:a randomized phase II trial[J].Ann Surg Oncol, 2012,19(7):2256-2263.
[4]中国抗癌协会肝癌专业委员会,中国抗癌协会临床肿瘤学协作专业委员会,中华医学会肝病学会肝癌学组全国肝胆肿瘤及移植病理协作组.原发性肝癌规范化病理诊断方案专家共识[J].中华医学杂志,2011,16(12):244-246.
[5]尹立楠,李任飞,杨坡,等.TACE联合其他介入手段治疗肝癌伴门静脉癌栓[J].现代生物医学进展,2015,15(6):1182-1185.
[6] Seki A, Hori S. Switching the loaded agent from epirubicin to cisplatin:salvage transcatheter arterial chemoembolization with drugeluting microspheres for unresectable hepatocellular carcinoma[J]. Cardiovasc Intervent Radiol, 2012,35(3):555-562.
[7]于志海,成科,王海涛.奥沙利铂联合表柔比星介入治疗原发性肝癌的临床研究[J].中华全科医学,2016,14(2):326-327.
[8]黎治平,王丽君,郑智.奥沙利铂神经毒性的中西医结合治疗进展[A].中华中医药学会岐黄论坛-血液病中医药防治分论坛[C],2014.
[9]张百红,岳红云.实体瘤疗效评价标准简介[J].国际肿瘤学杂志,2016,43(11):845-847.
[2]刘家贺,于全成.奥沙利铂联合表柔比星经导管肝动脉化疗栓塞介入治疗原发性肝癌临床分析[J].现代医药卫生,2014,30(5):743-744.
[3] Reni M, Balzano G, Aprile G, et al. Adjuvant PEFG(cisplatin, epirubicin, 5-fluorouracil, gemcitabine)or gemcitabine followed by chemoradiation in pancreatic cancer:a randomized phase II trial[J].Ann Surg Oncol, 2012,19(7):2256-2263.
[4]中国抗癌协会肝癌专业委员会,中国抗癌协会临床肿瘤学协作专业委员会,中华医学会肝病学会肝癌学组全国肝胆肿瘤及移植病理协作组.原发性肝癌规范化病理诊断方案专家共识[J].中华医学杂志,2011,16(12):244-246.
[5]尹立楠,李任飞,杨坡,等.TACE联合其他介入手段治疗肝癌伴门静脉癌栓[J].现代生物医学进展,2015,15(6):1182-1185.
[6] Seki A, Hori S. Switching the loaded agent from epirubicin to cisplatin:salvage transcatheter arterial chemoembolization with drugeluting microspheres for unresectable hepatocellular carcinoma[J]. Cardiovasc Intervent Radiol, 2012,35(3):555-562.
[7]于志海,成科,王海涛.奥沙利铂联合表柔比星介入治疗原发性肝癌的临床研究[J].中华全科医学,2016,14(2):326-327.
[8]黎治平,王丽君,郑智.奥沙利铂神经毒性的中西医结合治疗进展[A].中华中医药学会岐黄论坛-血液病中医药防治分论坛[C],2014.
[9]张百红,岳红云.实体瘤疗效评价标准简介[J].国际肿瘤学杂志,2016,43(11):845-847.