吉西他滨联合顺铂经肝动脉栓塞化疗治疗肝癌患者的效果
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摘要
目的探讨吉西他滨联合顺铂经肝动脉栓塞化疗(TACE)对肝癌患者的影响。方法选取我院2014年4月～2016年10月收治的60例肝癌患者作为研究对象,按照治疗方法的不同将其分为对照组与观察组,每组各30例。对照组患者采用氟尿嘧啶经TACE治疗,观察组患者采用吉西他滨+顺铂经TACE治疗,比较两组患者的指标变化。结果观察组患者治疗后1年内的总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。观察组患者治疗前的血清血管内皮生长因子(VEGF)、组织生长因子(CTGF)、可溶性白介素-2受体(sIL-2R)、缺氧诱导因子2α(HIF-2α)水平与对照组比较,差异无统计学意义(P>0.05)。两组患者治疗后的血清VEGF、CTGF、sIL-2R、HIF-2α水平与治疗前比较,差异有统计学意义(P<0.05)。观察组患者治疗后的血清VEGF、CTGF、sIL-2R、HIF-2α水平均低于对照组,差异有统计学意义(P<0.05)。观察组患者随访2年的生存率为63.33%,高于对照组的36.67%,差异有统计学意义(P<0.05)。观察组患者的不良反应发生率为13.33%,与对照组的16.67%比较,差异无统计学意义(P>0.05)。结论吉西他滨联合顺铂经TACE对肝癌患者治疗的效果明显,不增加毒副作用,具有重要的推广应用价值。
Objective To discuss the effect of transarterial chemoembolization(TACE) in the treatment of patients with hepatocellular carcinoma. Methods A total of 60 patients with hepatocellular carcinoma admitted to our hospital from April 2014 to October 2016 were selected as the research objects. They were divided into the control group and the observation group according to the different treatment methods, 30 cases in each group. The control group was treated with Fluorouracil and TACE, while the observation group was treated with Gemcitabine plus Cisplatin and TACE, and the index changes of the two groups were compared. Results The total effective rate of the observation group in one year after treatment was 93.33%, which was higher than that of the control group(73.33%), and the difference was statistically significant(P<0.05). There were no significant differences in levels of serum vascular endothelial growth factor(VEGF), tissue growth factor(CTGF), soluble interleukin-2 R(sIL-2 R), hypoxia inducible factor-2α(HIF-2α)between the observation group and the control group before treatment(P>0.05). The levels of serum VEGF, CTGF, sIL-2 R and HIF-2α in the two groups after treatment were significantly different from those before treatment(P<0.05). The levels of serum VEGF, CTGF, sIL-2 R and HIF-2α in the observation group after treatment were lower than those in the control group, and the differences were statistically significant(P<0.05). The 2-year survival rate in the observation group was 63.33%, which was higher than 36.67% in the control group, and the difference was statistically significant(P <0.05). The incidence rate of adverse reactions was 13.33% in the observation group and 16.67% in the control group, there was no significant difference between the two groups(P>0.05). Conclusion Gemcitabine combined with Cisplatin via TACE has obvious curative effect on patients with hepatocellular carcinoma, without increasing toxicity and side effects. It has important promotion and application value.
Objective To discuss the effect of transarterial chemoembolization(TACE) in the treatment of patients with hepatocellular carcinoma. Methods A total of 60 patients with hepatocellular carcinoma admitted to our hospital from April 2014 to October 2016 were selected as the research objects. They were divided into the control group and the observation group according to the different treatment methods, 30 cases in each group. The control group was treated with Fluorouracil and TACE, while the observation group was treated with Gemcitabine plus Cisplatin and TACE, and the index changes of the two groups were compared. Results The total effective rate of the observation group in one year after treatment was 93.33%, which was higher than that of the control group(73.33%), and the difference was statistically significant(P<0.05). There were no significant differences in levels of serum vascular endothelial growth factor(VEGF), tissue growth factor(CTGF), soluble interleukin-2 R(sIL-2 R), hypoxia inducible factor-2α(HIF-2α)between the observation group and the control group before treatment(P>0.05). The levels of serum VEGF, CTGF, sIL-2 R and HIF-2α in the two groups after treatment were significantly different from those before treatment(P<0.05). The levels of serum VEGF, CTGF, sIL-2 R and HIF-2α in the observation group after treatment were lower than those in the control group, and the differences were statistically significant(P<0.05). The 2-year survival rate in the observation group was 63.33%, which was higher than 36.67% in the control group, and the difference was statistically significant(P <0.05). The incidence rate of adverse reactions was 13.33% in the observation group and 16.67% in the control group, there was no significant difference between the two groups(P>0.05). Conclusion Gemcitabine combined with Cisplatin via TACE has obvious curative effect on patients with hepatocellular carcinoma, without increasing toxicity and side effects. It has important promotion and application value.
引文
[1]喻雄杰,李艳丽,雷金华,等.吉西他滨热化疗灌注联合TACE对肝癌患者疗效及肿瘤细胞因子水平的影响[J].医学综述,2016,22(20):4107-4110.
[2]吴润芝,张为群,王信成,等.TACE联合利卡汀治疗对肝癌患者病理指标及CTCs检出数的影响[J].中国现代医学杂志,2017,27(28):29-35.
[3]杨莹,康静波,张新红,等.经导管动脉化疗栓塞(TACE)联合射波刀治疗肝癌患者的临床疗效、并发症及生活质量的影响[J].中国医疗设备,2016,12(S1):158-159.
[4]李恒飞,徐庆,沈银峰,等.康艾注射液对TACE联合MWA治疗后肝癌患者疗效影响的研究[J].癌症进展,2017,15(5):515-517.
[5]李步天,章盛平.单纯TACE与联合肿瘤间质治疗对肝癌患者免疫球蛋白、补体和T细胞亚群的影响[J].海南医学院学报,2016,22(16):1863-1865.
[6]刘学芬,冉文华,彭东,等.GEMOX栓塞化疗联合三维适形放疗治疗局部晚期原发性肝癌临床研究[J].现代生物医学进展,2017,17(4):720-724.
[7]刘方伶.奥沙利铂联合表柔比星在原发性肝癌经导管动脉化疗栓塞治疗中的临床疗效和安全性分析[J].中国临床医生杂志,2017,45(7):69-71.
[8]谢焕琴,钟武装.TACE联合HIFU治疗老年原发性肝癌疗效及对患者免疫功能的影响[J].河北医学,2017,23(11):1761-1764.
[9]温力.吉西他滨联合顺铂新辅助化疗对膀胱癌根治术患者预后的影响[J].实用癌症杂志,2016,31(9):1498-1500.
[10]冯智毅,罗超元,李伟明.索拉非尼联合TACE对晚期肝癌患者肝功能及血清VEGF的影响[J].北方药学,2016,15(2):143-144.
[11]童玉云,张磊,王家平,等.多西他赛联合碘化油TACE治疗原发性肝癌的应用[J].昆明医科大学学报,2016,37(3):60-66.
[12]鲍乐,袁磊,张辉,等.不同给药方案介入治疗原发性肝癌的临床疗效与安全性分析[J].中国现代医生,2016,54(11):69-71.
[13]黄书明,陈圣开,张涛.肝癌切除术联合术后TACE对肝癌合并门静脉癌栓患者的治疗效果及预后影响因素分析[J].中国医学前沿杂志(电子版),2016,8(6):160-164.
[14]于卫辉,白淇文,肖金成.TACE联合射频消融对初发性及复发性肝癌的疗效及对预后影响因素研究[J].中国卫生工程学,2017,16(2):203-205.
[15]李红云.康莱特注射液联合吉西他滨与顺铂化疗方案治疗晚期非小细胞肺癌的临床疗效及其对免疫功能的影响[J].实用心脑肺血管病杂志,2017,12(5):121-123.
[2]吴润芝,张为群,王信成,等.TACE联合利卡汀治疗对肝癌患者病理指标及CTCs检出数的影响[J].中国现代医学杂志,2017,27(28):29-35.
[3]杨莹,康静波,张新红,等.经导管动脉化疗栓塞(TACE)联合射波刀治疗肝癌患者的临床疗效、并发症及生活质量的影响[J].中国医疗设备,2016,12(S1):158-159.
[4]李恒飞,徐庆,沈银峰,等.康艾注射液对TACE联合MWA治疗后肝癌患者疗效影响的研究[J].癌症进展,2017,15(5):515-517.
[5]李步天,章盛平.单纯TACE与联合肿瘤间质治疗对肝癌患者免疫球蛋白、补体和T细胞亚群的影响[J].海南医学院学报,2016,22(16):1863-1865.
[6]刘学芬,冉文华,彭东,等.GEMOX栓塞化疗联合三维适形放疗治疗局部晚期原发性肝癌临床研究[J].现代生物医学进展,2017,17(4):720-724.
[7]刘方伶.奥沙利铂联合表柔比星在原发性肝癌经导管动脉化疗栓塞治疗中的临床疗效和安全性分析[J].中国临床医生杂志,2017,45(7):69-71.
[8]谢焕琴,钟武装.TACE联合HIFU治疗老年原发性肝癌疗效及对患者免疫功能的影响[J].河北医学,2017,23(11):1761-1764.
[9]温力.吉西他滨联合顺铂新辅助化疗对膀胱癌根治术患者预后的影响[J].实用癌症杂志,2016,31(9):1498-1500.
[10]冯智毅,罗超元,李伟明.索拉非尼联合TACE对晚期肝癌患者肝功能及血清VEGF的影响[J].北方药学,2016,15(2):143-144.
[11]童玉云,张磊,王家平,等.多西他赛联合碘化油TACE治疗原发性肝癌的应用[J].昆明医科大学学报,2016,37(3):60-66.
[12]鲍乐,袁磊,张辉,等.不同给药方案介入治疗原发性肝癌的临床疗效与安全性分析[J].中国现代医生,2016,54(11):69-71.
[13]黄书明,陈圣开,张涛.肝癌切除术联合术后TACE对肝癌合并门静脉癌栓患者的治疗效果及预后影响因素分析[J].中国医学前沿杂志(电子版),2016,8(6):160-164.
[14]于卫辉,白淇文,肖金成.TACE联合射频消融对初发性及复发性肝癌的疗效及对预后影响因素研究[J].中国卫生工程学,2017,16(2):203-205.
[15]李红云.康莱特注射液联合吉西他滨与顺铂化疗方案治疗晚期非小细胞肺癌的临床疗效及其对免疫功能的影响[J].实用心脑肺血管病杂志,2017,12(5):121-123.