吉西他滨为主的化疗方案治疗晚期原发性肝细胞癌的临床观察

Clinical Observation on Chemotherapy Based on Gemcitabine for Treatment of Advanced Primary Hepatocellular Carcinoma

目的评估吉西他滨(GEM)为主的化疗方案治疗晚期原发性肝细胞癌的疗效和安全性。方法晚期原发性肝细胞癌患者89例用GEM为主方案进行化疗,其中GEM+优氟泰(UFT)41例,GEM+奥沙利铂(L-OHP)48例。按照RECIST 1.1版标准评估疗效,按照CTCAE3.0的毒性标准评估化疗不良反应。结果 86例可评价疗效,客观有效率(ORR)及疾病控制率(DCR)分别为19.8%和50.0%;中位生存期为6.2个月,累积半年生存率为53.5%,1年生存率为23.3%,2年生存率为3.5%。GEM+UFT方案与GEM+L-OHP方案的ORR、DCR及中位生存期分别为20.0%、19.6%;47.5%、52.2%;6.0个月、6.3个月,差异无统计学意义(P均>0.05)。两组不良反应发生率比较,差异无统计学意义(P均>0.05)。结论 GEM为主的联合方案治疗晚期肝癌有较好的临床疗效,不良反应可耐受;GEM联合优氟泰方案与GEM联合奥沙利铂方案疗效相似,但前者使用较方便。

Objective To evaluate the efficacy and safety of chemotherapy based on gemcitabine （ GEM） for the treatment of advanced primary hepatocellular carcinoma .Methods Eight-nine patients with advanced primary hepatocellular carcinoma recieved chemotherapy based on GEM ,including 41 cases treated with GEM plus UFT and 48 cases treated with GEM plus L-OHP.The efficacy was assessed based on RECIST 1.1,and the adverse events were evaluated according to CTCAE 3.0.Results Eight-six patients were assessable for efficacy .The objective response rate（ORR）,disease control rate（DCR） were 19.8%and 50.0%,respectively;The median survival was 6.2 months;The cumulative half-a-year,1-year,2-year survival rates were 53.5%,23.3%and 3.5%,respectively.The ORR,DCR and median survival showed no significant difference between GEM ＋UFT group and GEM＋L-OHP group（20.0%vs. 19.6%,47.5% vs.52.2%,6.0 months vs.6.3 months,all P〉0.05）.The adverse reactions showed no significant difference between two groups （all P〉0.05）.Conclusion The combination chemotherapy based on GEM is of good clinical efficacy for the treatment of advanced primary hepatocellular carcinoma ,and the adverse reactions could be tolerated . The efficiency of GEM＋UFT regimen is similar to that of GEM ＋L-OHP regimen ,but the former regimen is of simpler operation.