奥曲肽在可切除肝癌术后应用的临床疗效观察

Therapeutic effects of octreotide in the treatment of resectable hepatocellular carcinoma

目的 观察奥曲肽对手术可切除的生长抑素受体1 (SSTR1 )阳性的肝细胞肝癌的治疗作用。方法 回顾性分析 1 999年 5月至 2 0 0 3年 5月可切除原发性肝癌 4 2例的临床资料。其中 ,SSTR1 阳性 1 8例术后采用奥曲肽皮下注射 1 2周 ;SSTR1 阴性 2 4例为对照组。结果 奥曲肽治疗组和对照组 2年生存率分别 87.5 %和 5 0 % ,差异有显著性意义 (χ2 =5 .6 2 5 ,P <0 .0 5 )。 2年肿瘤复发率分别为 2 5 %和 5 5 % ,差异有显著意义 (χ2 =4 .4 2 5 ,P <0 .0 5 )。术后 2年生活质量QOL评分 ,治疗组平均为 5 4 .32分 ,为良好 ;对照组平均为 4 7.4 6分 ,为较好。治疗 3月后 ,AFP下降率治疗组为88.88% ,对照组为 5 8.33% ,差异有显著性意义 (χ2 =4 .70 6 ,P <0 .0 5 )。结论 术后应用奥曲肽能明显改善肝癌病人的生活质量 ,延长生存期 ,减少肿瘤复发 。

Objective To observe the therapeutic effects of octreotide in the treatment of resectable hepatocellular carcinoma positive for SSTR 1 staining.Methods 42 patient with resectable hepatocellular carcinoma were divided into two groups.Group A( n =18 positive for SSTR 1 staining)was subjected to the subcutaneous injection of octreotide postoperatively,while group B( n =24 negative for SSTR 1 staining)served as control group. The 2 year survival rate in groups A and B was 87.5% and 50% respectively.There was significant difference between group A and B( P < 0.05 ).The 2 year recurrence rate in groups A and B was 25% and 55% respectively with the difference being significant between them( P < 0.05 ).Two years after operation,scores of QOL in groups A and B were 54.32 and 47.46 respectively.After treatment for 3 months,the decreased rate of AFP level in group A and group B was 88.88% and 58.33% respectively with the difference being significant( P < 0.05 ).Conclusion Postoperative administration of octreotide,which can significantly improve the QOL of the patients,prolong the survival and reduce recurrence of tumor,is one of the valuable alternative in the treatment of primary hepatocellular carcinoma.