沙利度胺联合FOLFOX方案治疗晚期肝癌的临床效果观察

Clinical Efficacy of Thalidomide Combined with FOLFOX4 in Treatment of Advanced Liver Cancer

目的：探讨沙利度胺联合FOLFOX4方案治疗晚期肝癌的临床疗效。方法：回顾性分析我院2011年6月~2013年7月收治的70例晚期肝癌患者的资料,随机分为观察组和对照组,各35例,两组患者均采用奥沙利铂（L-OHP）联合5-氟尿嘧啶（5-FU）/亚叶酸钙（CF）组成的FOLFOX4化学治疗（化疗）方案,观察组患者同期行沙利度胺联合化疗,1个月后确定疗效,比较两组患者近期缓解率、化疗后毒副作用以及血清血管内皮生长因子（VEGF）变化情况。结果：观察组患者近期缓解率明显高于对照组,比较差异有统计学意义（P〈0.05）。两组患者化疗后VEGF含量均下降,观察组患者下降更为明显,比较差异有统计学意义（P〈0.05）。观察组患者嗜睡、乏力、头晕、皮疹等症状发生率高于对照组,比较差异有统计学意义（P〈0.05）。结论：沙利度胺联合FOLFOX4方案治疗晚期肝癌,能提高患者疾病控制率,降低血清VEGF水平,毒副作用可耐受,值得在临床推广。

Objective：To investigate the clinical efficacy of thalidomide combined with FOLFOX4 treatment of advanced liver cancer.Methods：A retrospective analysis was performed on 70 patients with advanced liver cancer in our hospital in June 2011 ~July 2013.All of the patients were randomly divided into the observation group and the control group,and each group contains 35 cases respectively.Patients in Both of the two groups were treated with oxaliplatin（L-OHP） combined with 5-fluorouracil（5-FU）/leucovorin（CF） FOLFOX4 chemotherapy regimen while patients of the observation group were treated with thalidomide in combination with FOLFOX4 chemotherapy.Clinical efficacy was evaluated and the recently remission rate,toxic effects and serum vascular endothelial growth factor（VEGF） changes between the two groups were compared one month later.Results：The recently response rate was significantly higher in patients of the observation group than the control group and the difference was statistically significant（P〈0.05）.The decrease of VEGF levels was observed in both two groups after chemotherapy and more significant in the observation group（P〈0.05）.The incidence of somno lence,fatigue,dizziness,skin rashes and other symptoms in the observation group were higher and the difference was statistically significant（P〈0.05）.Conclusion：Thalidomide combined with FOLFOX4 treatment of advanced liver cancer can improve chemotherapy response rate and lower the serum VEGF levels.The side effects can be tolerated.