替吉奥与沙利度胺联合肝动脉栓塞化疗治疗中晚期肝细胞癌的临床观察

Clinical effect of transcatheter arterial chemoembolization combined with gimeracil and oteracil potassium and thalidomide in treatment of advanced hepatocellular carcinoma

目的:观察经肝动脉栓塞化疗(TACE)单用或联合替吉奥与沙利度胺治疗中晚期肝细胞癌(HCC)的疗效。方法:将2010年8月-2012年8月本院收治的无法手术切除的中晚期HCC患者80例随机分为2组,每组40例。治疗组采用TACE联合替吉奥与沙利度胺口服,对照组仅行TACE治疗。比较两组的有效率、疾病控制率、生存率以及不良反应情况。结果:治疗组有效率67.5%,对照组30.0%,差异有统计学意义(P=0.001);治疗组疾病控制率92.5%,对照组37.5%,差异有统计学意义(P=0.000)。治疗组1年生存率80.0%,对照组50.0%,差异有统计学意义(P=0.005);治疗组2年生存率42.5%,对照组10.0%,差异有统计学意义(P=0.001)。两组不良反应轻微,主要为恶心呕吐、便秘和骨髓抑制,为I、II级,对症治疗可缓解,两组比较差异无统计学意义(P>0.05)。结论:替吉奥与沙利度胺联合TACE术对中晚期HCC有一定的治疗价值,值得进一步观察。

Objective：To evaluate the clinical effect of transcatheter arterial chemoembolization（ TACE）alone or combined with gimeracil and oteracil potassium（S-1）and thalidomide in treatment of advanced hepatocellular carci-noma（ HCC）. Methods：All 80 patients with unresectable advanced HCC,who were admitted to our hospital from Au-gust 2010 to August 2012,were randomly divided into treatment group（n=40）and control group（n=40）. The treat-ment group was treated with TACE combined with S-1 and thalidomide,and the control group with TACE alone. The response rates,disease control rates,survival rates,and adverse reactions of both groups were evaluated. Results：Com-pared with the control group,the treatment group had a significant higher response rate（P =0. 001）,a significant higher disease control rate（P=0. 000）,a significant higher 1-year survival rate（P=0. 005）,and a significant high-er 2-year survival rate（P=0. 001）. Mild adverse reactions（grade I or II ）were seen in two groups,including nausea,vomiting,constipation,and bone marrow suppression. These adverse reactions could be reduced by symptomatic treat-ment and showed no significant differences between the two groups（P〉0. 05）. Conclusion：The combination therapy with S-1 and thalidomide plus TACE is effective in the treatment of advanced HCC and is worth further study.