奥曲肽联合经动脉插管化疗栓塞治疗伴肝硬化肝细胞癌

Octreotide in combination with transcatheter arterial chemoembolization for hepatocellular carcinoma associated with liver cirrhosis

目的评价奥曲肽联合经动脉插管化疗栓塞(TACE)治疗伴肝硬化肝细胞癌的临床效果。方法选择Child-Pugh评分A或B级伴肝硬化肝细胞癌患者共55例。实验组24例,行TACE术后第1天开始使用奥曲肽0.2mg皮下注射,每天2次。对照组31例,接受TACE治疗。每3个月进行1次评价。对两组6个月及1、2、3年的生存率进行比较。结果两组均无CR,实验组中16例PR,有效率为66.67%。对照组中11例PR,有效率为35.48%。两组有效率差异有显著性(P<0.05)。实验组3年生存率为45.83%,而对照组3年生存率为19.35%。两组3年生存率差异有显著性(P<0.05)。实验组中位生存期为31个月,对照组中位生存期为20个月。实验组中位TTP为9个月,对照组为6个月。奥曲肽副作用主要为轻度腹泻。结论奥曲肽联合TACE治疗伴肝硬化肝细胞癌有明确的效果。

Objective This article is to evaluate the effects of octreotide in combination with transcatheter arterial ehemoembolization （TACE） for hepatocellular carcinoma complicated with liver cirrhosis Methods Fifty - five consecutive patients in Child-Pugh classification A and B were admitted into the 3 - year trial. Twenty - four patients in the octreotide group received octreotide 0.2mg IH twice a day following the treatment of TACE on day 1. Thirty- one patients received TACE alone were enrolled into the control group. The efficacy were assessed once every 3 months. A comparison of the 6 -month,1 - year,2 - year and 3 - year survival rate between the two groups were performed Results No complete response was got in both groups. In the octreotide group, partial response （PR） was got in 16 （66.67%） of the 24 patients, whereas in the control group, PR was achieved in 11（35.48%） of the 31 patients. There was statistical significant difference in response rate between the two groups （ P 〈0.05）. The 3 - year overall survival rate of the octreotide group and the control group were 45.83 % and 19.35%, respectively. There was statistical significant difference in 3 - year overall survival rate between the two groups （ P 〈 0. 05）. The overall survival rate of the octreotide group was significantly higher than that of the control group （p 〈 0. 05）, The median survival of the octreotide group and the control group were 31 months and 20 months, respectively. The aliment development in the octreotide group was 9 months vs 6 months in the control group. The major complication of the octreotide treatment was mild diarrhea. Conclusion It was effective of octreotide in combination with TACE for hepatocellular carcinoma associated with liver cirrhosis.