结直肠癌肝转移105例姑息性治疗的回顾性分析

Palliative treatment of colorectal cancer combined with hepatic metastases in 105 cases:a retrospective analysis

目的:探讨结直肠癌肝转移肝动脉灌注联合全身化疗在结直肠癌肝转移患者中的作用及影响预后的因素。方法:105例患者分成A组(全身化疗)和B组(介入+全身化疗),采用Kaplan-Meier法和log-rank法,根据每组治疗的中位无进展生存(median time to progression,mTTP)期、总生存(overall survival,OS)期及出现肝转移后生存(overall survival after hepatic metastasis,OSL)期等因素,进行回顾性比较分析。结果:A组和B组间在性别、肝外转移例数、行为能力(Karnofsky perform-ance status,KPS)评分、癌胚抗原(carcinoembryonic antigen,CEA)值、肝内转移灶数目、肝转移灶大小、化疗药物种类、化疗方案和病理分级等经2组间χ2检验,差异均无统计学意义(P>0.05);2组间年龄经单因素方差齐性检验显示方差齐,2组间t检验,差异无统计学意义(P>0.05);A组和B组mTTP、OS、OSL期的差异均有统计学意义(P<0.05)。结论:综合治疗(介入+全身化疗)的疗效优于单纯全身化疗。

Objective：To observe the efficiency of interventional therapy combined with systemic chemotherapy and analyze the prognostic factors in the patients with colorectal cancer with hepatic metastases. Methods：One hundred and five patients were divided into group A （only systemic chemotherapy） and group B （interventional therapy combined with systemic chemothe- rapy）. Based on Kaplan-Meier survival analyses and log-rank test, this study made a retrospective analysis on median time to pro- gression （mTFP）, overall survival （OS）, and overall survival after hepatic metastasis （OSL）. Results：There was no significant difference in gender, extra metastasis, KPS score, CEA level, the number of metastasis, the size of metstatic lesions, kinds of chemotherapeutic drugs, chemotherapeutic regimens, and pathological grade between the two groups （X2 test, P 〉 0.05 ）. The age was not significantly different between the two groups （ t test, P 〉 0.05 ）. A significant difference was found in mTTP, OS and OSL between group A and group B （ P 〈 0.05 ）. Conclusion： Comprehensive treatment based on interventional therapy combined with systemic chemotherapy achieved better clinical outcome than single systemic chemotherapy.