吉西他滨联合亚砷酸治疗不能切除肝癌的临床研究

Clinical study of Gemcitabine Combined with Arsenic Trioxide in Treatment of Unresectable Hepatocellular Carcinoma

目的观察吉西他滨联合亚砷酸治疗不能切除肝癌的临床疗效。方法 68例患者随机分为观察组和对照组各34例,对照组采用吉西他滨联合奥沙利铂化疗,观察组采用吉西他滨联合亚砷酸化疗,比较两组的疗效和毒副反应。结果全部患者均可评价疗效,两组有效率和疾病控制率均无明显差别(26.5%vs.17.6%,70.6%vs.55.9%,P>0.05)。观察组骨髓抑制和胃肠道反应的发生率显著低于对照组(P<0.05);观察组中位肿瘤进展时间为7.6个月,中位生存期为12.4个月,半年、1年、2年生存率分别为73.5%、55.9%和26.5%,对照组的中位肿瘤进展时间为5.8个月,中位生存期为9.7个月,半年、1年、2年生存率分别为47.1%、26.5%和5.9%,两组比较差异均有统计学意义(P<0.05)。结论吉西他滨联合亚砷酸治疗不能切除肝癌具有良好的临床疗效,毒副反应较轻,值得临床推广。

Objective To observe the clinical effect of gemcitabine combined with arsenic trioxide in treatment of unresectable hepatocellular carcinoma.Methods A total of 68 patients were randomly divided into test group and control group with 34 cases in each group.The control group was treated with gemcitabine plus oxaliplmin, and the test group was treated wi＊h gemcitabine plus arsenic trioxide. The clinical effects and toxic and adverse effects of the two groups were compared.Results There were no significant difference between the two groups response rate and disease control rate （26.5% vs 17.6%,70.6% vs 55.9% ,P〉0.05）.The incidence of myelosuppression and gastrointestinal reactions of test group was significantly lower than the control group （P 〈0.05）. In test group, the median time to progression was 7.6 months,the median survival time was 12.4 months, half-, 1-,2-year survival rates were 73.5%, 55.9% and 26.5%, and those of control group were 5.8 months,9.7 months,47.1%, 26.5 % and 5.9%.There were significant differences between the two groups （P〈0.05）.Conclusion The clinical effect of gemcitabine combined with arsenic trioxide in treatment of unresectable hepatocellular carcinoma is satisfying, the toxicity is mild, and it is worthy of further clinical studies.