时辰化疗方案与FOLFOX4方案治疗晚期肝癌的临床对比性研究

Clinical comparative analysis on chrono-chemotherapy and FOLFOX4 in the treatment of advanced primary hepatocellular cancer

目的对比FOLFOX4常规方案与时辰化疗方案治疗晚期原发性肝癌的近期疗效及毒副反应。方法选取2011年1月至2012年6月经病理和（或）组织细胞学确诊为晚期原发性肝癌患者60例，随机分为时辰化疗组和常规化疗组各30例，观察并比较两组临床疗效及不良反应发生情况。结果常规化疗组部分缓解5例，病灶稳定9例，疾病进展16例；时辰化疗组部分缓解13例，病灶稳定9例，疾病进展8例。不良反应以骨髓抑制、消化道不良反应和肝肾功能损伤为主，多为1～2级。时辰化疗组生活质量的改善优于常规化疗组。结论FOLFOX4时辰化疗方案治疗晚期原发性肝癌优于常规方案，可进一步提高疗效，降低毒副作用，具有临床推广价值。

Objective To study the clinical effects and toxicity between chrono-chemotherapy of FOLFOX4 and conventional chemotherapy of in the treatment of advanced primary hepatocellular cancer. Methods Selecting 60 cases from Jan 2011 to Jun 2012 in our hospital. All of the cases were diagnosed as advanced primary hepatocellular cancer by pathological examination or histiocytes and then they were randomly divided into the control group （n=30, conventional chemotherapy of FOLFOX4） and the experimental group （n-30, chrono-chemotherapy of FOLFOX4）, follow-up was conducted and we observed curative effect and complications of two groups, and compared the efficacy and safety. Results The control group had 5 cases of partial remission, 15 cases of disease progression and others were stable, the experimental group had 15 cases of partial remission, 8 cases of disease progression, 9 stable cases. The adverse reactions were mainly bone marrow suppression, gastrointestinal reaction and liver/kidney damage, with majority of them in grade 1 or 2. The quality of life improvement of the experimental group was better than that of control group, showing statistical significant difference. Conclusion Chrono-chemotherapy of FOLFOX4 in treating advanced primary hepatocellular cancer, compared with that of conventional method, has better effect, lower adverse reaction and it is a preferable chemotherapy for clinical promotion.