重组人血管内皮抑素联合经皮肝动脉化学栓塞术治疗中晚期原发性肝癌

Recombinant human endostatin combined with transcatheter arterial chemoembolization for treatment of advanced hepatocellular carcinoma

目的:观察重组人血管内皮抑素联合经皮肝动脉化学栓塞术治疗中晚期原发性肝癌的疗效及安全性。方法:将临床确诊的中晚期原发性肝癌60例分成两组,对照组采用常规经皮肝动脉化学栓塞术治疗,治疗组采用血管内皮抑素联合经皮肝动脉化学栓塞术治疗。观察治疗后两组近期疗效、甲胎蛋白(alpha-fetal protein,AFP)变化和1、2年生存率,同时比较治疗的不良反应。结果:治疗组与对照组总有效率相比差异有统计学意义(χ2=4.286,P<0.05)。治疗组与对照组AFP好转分别为17例、10例,AFP稳定分别为10例、14例。治疗组和对照组中位生存期分别为14.1个月(6.3～24.0个月)、9.8个月(5.7～24.0个月);治疗组和对照组1、2年生存率分别为(83.3±3.5)%、(40.0±6.1)%和(60.0±3.4)%、(30.0±7.3)%,两组比较,1年总生存率差异有统计学意义(P<0.05),2年总生存率差异无统计学意义(P>0.05)。治疗组和对照组均未发生严重的不良反应。两种血管内皮抑素给药方式不良反应发生率相差不大。结论:血管内皮抑素联合经皮肝动脉化学栓塞术治疗中晚期原发性肝癌近期疗效好,且安全有效,值得临床进一步推广。

Objective To investigate the efficacy and safety of combined therapy of recombinant human endostatin plus transcatheter arterial ehemoembolization （TACE） for advanced hepatocellular carcinoma. Methods Sixty patients with advanced hepatocellular carcinoma were equally and randomly divided into study group and control group. Patients in study group received the combined therapy of endostatin plus TACE, while patients in control group received conventional TACE only. After the combined therapy, the overall response rate （CR＋PR）, the value of alpha-fetoprotein（AFP）, the 1-year and the 2-year survival rates were surveyed and assessed. The adverse effects were compared between the two groups. Results Compared with the control group, the overall response rates of the study group were markebly higher （X^2 = 4.286 ,P 〈 0.05 ）. The AFP level improved cases and AFP level stable cases of the study group and the control group were 17,10 and 10,14. The median survival was 14.1 months（6.3 to 24.0 months） in the study group and 9.8 months（5.7 to 24.0 months） in the control group. The 1-year and 2-year survival rates of the study group and the control group were （83.3±3.5）%, （40.0 ± 6.1 ）%and （60.0 ± 3.4）%, （30.0 ± 7.3）%.The 1-year survival rates between the two groups has a statistical significance （P〈 0.05）, while the 2-year survival rates not（P 〉 0.05）. No obvious adverse effects were observed in the two groups. The incidence of endostatin side effects were not much difference between the two different administration methods. Conclusion The treatment of endostatin plus TACE for advanced hepatocellular carcinoma demonstrated a better short-term curative effect with fewer side-effects, and is worthy of clinical generalization.