注射用薏苡仁提取物联合TACE术治疗转移性肝癌的临床疗效分析

The effect of Coix Seed Extract combined with transcatheter arterial chemoembolization in the treatment of hepatic metastases

目的:观察注射用薏苡仁提取物联合经导管肝动脉化疗栓塞术(transcatheter arterial chemoemboliza-tion,TACE)对转移性肝癌的疗效及安全性以及治疗前后血清血管内皮生长因子(vascular endothelial growthfactors,VEGF)的变化及疗效的关系。方法:将62例转移性肝癌患者随机分为治疗组及对照组,每组各31例。治疗组:采用注射用薏苡仁提取物+TACE术。对照组:单纯用TACE术。两组均至少治疗2个周期。结果:治疗组有效率为61.3%(19/31),对照组45.2%(14/31),(P>0.05);治疗组疾病控制率(disease control rate,DCR)为80.6%(25/31),对照组为54.8%(17/31),P<0.05。治疗组1年生存率为67.7%(21/31),对照组38.7%(12/31),(P<0.05);治疗组中位无进展生存期(PFS)为7.0月,对照组为5.1月,(P<0.05);治疗组生活质量改善率74.2%(23/31),对照组48.4%(15/31),治疗组明显高于对照组,差异有统计学意义(P<0.05);血清VEGF治疗组治疗后下降显著(P<0.05);对照组治疗前后血清VEGF水平对比无显著性差异(P>0.05);治疗组治疗后血清VEGF水平较对照组治疗后水平明显低下,差异有统计学意义(P<0.05);两组不良反应均为Ⅰ-Ⅲ级,治疗组乏力、食欲下降及右上腹疼痛症状较对照组偏低。结论:注射用薏苡仁提取物联合TACE术治疗转移性期肝癌能提高疾病控制率,并降低血清VEGF水平,延长中位无进展生存期及1年生存率,改善临床症状、提高生活质量。

Objective：To evaluate the therapeutic efficacy and adverse reactions of Coix Seed Extract combined with transcatheter arterial chemoembolization （TACE）in the treatment of hepatic metastases and to compare the levels of serum VEGF of the patients before and after the treatment. Methods： From July 2009 to July 2011,62 patients with hepatic metastases were divided into combining group and control group. The combining group was treated by TA- CE combined with Coix Seed Extract, and the control group was treated with TACE only. Both groups underwent TA- CE at least twice. Before and after the treatment, the enzyme linked immunosorbentassay （ELISA）was used to exam- ine the change of VEGF. Results： Of 62 assessable patients, overall response rate was 61.3% （ 19/31 ） in combining group and 45.2% （ 14/31 ） in control group respectively （P 〉 0. 05 ）. The disease control rate was 80.6% （25/31） in combining group and 54.8% （ 17/31 ） in control group（P 〈 0.05）. 1 - year survival rates were 67.7% in combining group and 38.7% in control group（ P 〈 0. 05 ）. The median PFS （progression free survival time） was 7. Omonths in combining group and 5.1 months in control group（ P 〈 0. 05 ）. The quality of life was improved in combining group. The levels of serum VEGF in combining group were significantly decreased after treatment （ P 〈 0.05 ）. There was no significant difference between the levels of serum VEGF before and after treatment in control group （ P 〉 0.05 ）. The levels of serum VEGF in combining group after treatment were lower than that in control group after treatment （ P 〈 0. 05 ）. Adverse reactions in both groups were grade I to Ⅲ. The fatigue, anorexia and the right upper quadrant pain were sig- nificantly superior in combining group. Conclusion： Coix Seed Extract combined with transcatheter arterial chemoem- bolization in the treatment of hepatic metastases can improve disease control rate, decrease the levels of serum VEGF, improve clinical symptoms , improve the quality of life, prolong the PFS and 1 - year survival rate.