吉西他滨热化疗治疗肝癌的临床效果及对血清MGMT水平的影响

Clinical Efficacy of Gemcitabine Thermal Chemotherapy in the Treatment of Liver Cancer and Effect on the Serum MGMT Level

目的:探讨吉西他滨热化疗治疗肝癌的临床效果及对血清O6-甲基鸟嘌呤DNA甲基转移酶(O6-methylguanine-DNA methyltransferase,MGMT)水平的影响。方法:选取2014年2月-2017年4月在我院诊治的59例肝癌患者,根据治疗方法的方法不同分为观察组30例、对照组29例,对照组给予常规化疗,化疗观察3个周期;观察组在对照组化疗的基础上给予吉西他滨热灌注化疗,比较两组的临床疗效、不良反应的发生情况、生存情况及治疗前后血清MGMT表达的变化情况。结果:观察组患者的热灌注化疗均成功进行,治疗前后患者的体温、呼吸频率、心率、血压等对比无显著差异(P>0.05)。治疗后,观察组总有效率是66.7%,显著高于对照组(31.0%)(P<0.05)。两组治疗期间的毒性反应发生率间无显著差异(P>0.05)。两组治疗后血清MGMT表达都较治疗前显著降低(P<0.05),且观察组的血清MGMT表达明显比对照组低(P<0.05)。随访至2017年11月30日,观察组的疾病进展时间(Time to Progression,TTP)、生存时间(overall survival,OS)分别为8.11±2.19个月和14.29±1.87个月,都显著高于对照组的6.22±1.82个月和11.48±2.19个月(P<0.05)。结论:吉西他滨热化疗治疗肝癌可提高疗效,延长患者的生存时间,且不增加毒副反应,可能与其有效降低患者血清MGMT表达有关。

Objective: To explore the clinical efficacy of gemcitabine thermal chemotherapy in the treatment of liver cancer and effect on the serum O6-methylguanine DNA methyltransferase (MGMT) level. Methods: 59 cases of liver cancer patients in our hospital from February 2014 to April 2017 were selected as the research object. All the cases were divided into the observation group (30 cases) and the control group (29 cases) according to the methods of treatment. The control group was given conventional chemotherapy for 3 cycles and the observation group was given gemcitabine thermo perfusion chemotherapy based on the control group. The clinical efficacy, incidence of adverse reactions, survival and changes of serum MGMT expression before and after treatment were compared between the two groups. Results: The thermo perfusion chemotherapy was successfully performed in the observation group. There was no significant difference in the body temperature, respiratory rate, heart rate and blood pressure between two groups before and after treatment (P>0.05). The total effective rate of observation group and control group after treatment were 66.7% and 31% respectively, which was significantly higher in the observation group than that of the control group (P<0.05). There was no significant difference in the incidence of digestive tract reaction, blood system reaction, skin reaction and neurotoxic reaction between the two groups (P>0.05). After treatment, the serum MGMT levels of both groups were lower than those before treatment (P<0.05), which was also significantly lower in the observation group than that in the control group (P<0.05). Following up to November 30, 2017, the time to progression and overall survival in the observation group were 8.11±2.19 months and 14.29±1.87 months, respectively, which were significantly higher than those in the control group (6.22±1.82 months and 11.48±2.19 months)(P<0.05). Conclusions: Gemcitabine chemotherapy can improve the curative effect, prolong the survival time with high safety in the treatment of liver cancer, which may be related to effective reduction of serum MGMT level.