三氧化二砷联合奥沙利铂及吉西他滨经肝动脉化疗栓塞对肝细胞癌复发转移的影响

Effect of arsenic trioxide combined with oxaliplatin and gemcitabine arterial chemoembolization for hepatocellular carcinoma recurrence and metastasis ability

目的探讨三氧化二砷联合奥沙利铂及吉西他滨动脉化疗栓塞方案对原发性肝细胞癌复发转移的影响。方法将行肝细胞癌动脉化疗栓塞术的72例患者,分成观察组36例（用三氧化二砷联合奥沙利铂及吉西他滨动脉栓塞化疗方案）和对照组36例（用奥沙利铂及吉西他滨动脉栓塞化疗方案）。治疗3-4周期（每周期28 d）后评价治疗效果。结果观察组的客观缓解率为61.1%高于对照组的36.1%（x2=4.503,P=0.034）,观察组的疾病控制率为88.9%高于对照组的69.4%（x2=4.126,P=0.042）。两组治疗后2年和3年复发转移率及1年、2年、3年生存率比较差异均有统计学意义（P〈0.05）。两组患者治疗毒副反应的发生率比较差异无统计学意义（P〉0.05）,经对症治疗可缓解。结论三氧化二砷联合奥沙利铂及吉西他滨动脉化疗栓塞对控制原发性肝癌原发灶复发和新发转移上的效果较奥沙利铂及吉西他滨方案动脉化疗栓塞要好。

Objective To investigate the effect of arsenic trioxide combined with oxaliplatin and gemcit- abine arterial embolism chemotherapy on the recurrence of primary liver cell carcinoma metastasis. Methods 72 cases of patients with hepatocellular carcinoma arterial chemoembolization were divided into the observa- tion group （ 36 cases treated with arsenic trioxide combined with oxaliplatin and gemcitabine arterial embol- ism chemotherapy） and control group（36 cases with oxaliplatin and gemcitabine arterial embolism chemo- therapy ）. The treatment effect was determined after 3 - 4 cycles （ 28d per cycle I of treatment. Results Two groups of the objective response rate { RR } and disease control rate （ DCR ） were observed with 61. 1%, 88.9% in the observation group and 36.1%, 69.4% in control group respectively; RR and DCR in the ob- servaion group were obviously higher than that in the control group, the differences were statistically signifi- cant with x2=4. 503, 4. 126 and P=0.034, 0.042 respectively. The two groups after 2-year and 3-year recurrence rate and 1 years, 2-years, 3-years survival rate differences were statistically significant （P 〈0.05 ）. The toxic and side effects in both groups were common in clinical practice and could be relieved or improved by symptomatic treatment, and showed no significant differences between the two groups（P〉 0.05 ）. Conclusion The effect of arsenic trioxide combined with oxaliplatin and gemcitabine arterial chemo- embolization on the control of primary primary liver cancer recurrence and metastasis is better than the effect of oxaliplatin and gemcitabine arterial chemoembolization.