两种三联动脉化疗栓塞方案治疗无法切除原发性肝癌临床对比研究

Clinical comparative study of two kinds of triple therapy for arterial chemoembolization in the treatment of patients with primary hepatic carcinoma which can not be removed

目的:探讨雷替曲塞与洛铂分别辅助5-FU+表柔比星两种三联动脉化疗栓塞方案治疗无法切除原发性肝癌临床疗效及安全性差异。方法:研究对象选我院2011年5月-2013年5月收治无法切除原发性肝癌患者110例,采用抽签法分为A组(55例)和B组(55例),分别在5-FU+表柔比星基础上加用洛铂与雷替曲塞行动脉化疗栓塞;比较两组患者临床疗效,中位疾病进展时间,随访生存率,术后实验室指标改善情况及III-IV级毒副作用发生率。结果:B组患者疾病控制率显著高于A组,差异有统计学意义(P<0.05);B组患者中位无进展生存时间显著长于A组,差异有统计学意义(P<0.05);B组患者随访生存率显著高于A组,差异有统计学意义(P<0.05);B组患者术后实验室指标改善情况显著优于A组、治疗前,差异有统计学意义(P<0.05);两组患者III-IV级毒副作用发生率比较差异无统计学意义(P>0.05)。结论:雷替曲塞辅助5-FU+表柔比星三联动脉化疗栓塞方案治疗无法切除原发性肝癌可有效提高疾病控制效果,延长生存时间,且未诱发严重药物毒副作用,效果优于洛铂。

Objective：To investigate clinical effects and safety of two kinds of triple therapy for arterial chemoem-bolization including lobaplatin and raltitrexed assisted with epirubicin ＋ 5 - FU in the treatment of patients with prima-ry hepatic carcinoma which can not be removed. Methods：All 110 patients with primary hepatic carcinoma which can not be removed were chosen in the period from May 2011 to May 2013 in our hospital and randomly divided into two groups including A group（55 patients）with lobaplatin assisted with epirubicin ＋ 5 - FU and B group（55 patients） with raltitrexed assisted with epirubicin ＋ 5 - FU by arterial chemoembolization. The clinical efficacy,median time of disease progression,survival rate with follow - up,improvement levels of laboratory indexes and drug side effects inci-dence for III - IV degree of both groups were compared. Results：The clinical efficacy of B group was significant better than A group（P ﹤ 0. 05）. The median time of disease progression of B group was significant higher than A group（P ﹤0. 05）. The survival rate with follow - up of B group was significant higher than A group（P ﹤ 0. 05）. The improvement level of laboratory indexes of B group was significant better than A group（P ﹤ 0. 05）. There was no significant differ-ence in drug side effects incidence for III - IV degree between 2 groups（P ﹥ 0. 05）. Conclusion：Compared with lobaplatin,ltitrexed assisted with epirubicin ＋ 5 - FU in the treatment of patients with primary hepatic carcinoma which can not be removed by arterial chemoembolization can efficiently improve control effect of disease,prolong the survival time.