肝细胞癌根治性切除术后FOLFOX4辅助化疗的效果研究

Study of effects on FOLFOX4 as adjuvant chemotherapy after radical resection for hepatocellular carcinoma

目的研究肝细胞癌实施根治性切除术后应用辅助化疗能否降低复发率或改善总体生存率。方法回顾性分析本院2003年1月至2008年8月间115例肝癌(直径>5cm)病例。27例患者行肝癌根治性切除术后应用FOLFOX4化疗(实验组);88例患者仅行肝癌根治性切除术(对照组)。应用Kaplan-Meier方法分析生存曲线,Cox回归模型评估影响总体生存率的预后因素。结果 2组的临床病理资料无明显差异。实验组的27例患者接受中位数为6周期(4-12周期)的FOLFOX4辅助化疗:奥沙利铂(85mg/m2),亚叶酸钙(400mg/m2),5-氟尿嘧啶(2000mg/m2)。肿瘤复发时间(TTR)中位数:对照组11.9月,实验组14.9月(P=0.026)。1、2、3和5年总体生存率:对照组86%、60%、24%,9%;实验组为100%、78%、51%、17%(P=0.004)。结论对于直径大于5厘米的肝细胞癌患者,根治性切除术后予FOLFOX4辅助化疗能推迟肿瘤复发并改善总体生存率。

Objective To study whether postoperative adjuvant chemotherapy after radical hepatic resection would decline recurrence rate or improve total survival rate for large HCC. Methods From January 2003 to August 2008,the clinical data of 115 cases with large HCC were analyzed retrospectively.There were 27 patients who underwent radical hepatectomy with FOLFOX4 adjuvant chemotherapy （treatment group）and 88 patients who underwent radical hepatectomy only （control group）.Kaplan-Meier method was used to analyze survival curve and Cox regression model was used to evaluate the prognostic factors of overall survival. Results The clinicopathological data were no difference significantly between 2 groups. The median time to tumor recurrence （TTR） was 11.9 months in control group and 14.9 months in treatment group （P=0.026）. The 1-,2-,3-, and 5-year overall survival rates were 86%,60%,24%,and 9% in control group and 100%, 78%, 51%, and 17% in treatment group,respectively（P=0.004）. Conclusion For patient with HCC more than 5cm in diameter, postoperative adjuvant chemotherapy with FOLFOX4 after radical hepatectomy might delay the recurrence and improve total survival rate.