不同辅助化疗方式治疗晚期复治原发性肝癌的效果及生存分析

Different adjuvant chemotherapies for the retreatment patients with advanced primary hepatic ;carcinoma：an efficacy and survival analysis

目的：探讨不同化疗方式在晚期原发性肝癌复治患者治疗中的作用及疗效。方法回顾性分析病历资料完整的115例晚期复治原发性肝癌患者，按接受治疗方式不同分为介入化疗组（A组，40例）、全身热化疗组（B组，16例）、常规化疗组（C组，9例）、局部热疗联合化疗组（D组，26例）和支持治疗组（E组，24例），比较各组的治疗有效率及生存情况。结果 A、B、C组的治疗有效率分别为30.5%（12／40）、12.5%（2／16）、11.1%（1／9），三组相比差异无统计学意义（P〉0.05）。A-E组中位生存期分别为7.7、9.2、7.9、6.0、4.7个月，B组与E组相比差异有统计学意义（P〈0.05）。0.5、1、2年生存率均以B组为高，与E组比较差异均有统计学意义（81.2%比29.1%，37.5%比12.5%，12.5%比0，均P〈0.05）。结论晚期复治原发性肝癌常规单纯化疗的有效率并不高，介入及局部热化疗有效率较高，但并不延长患者生存期；全身性热化疗有助于提高患者的有效率，延长生存期。

Objective To study the significance of treating advanced primary hepatic carcinoma by using the different methods combined with chemotherapy. Methods One hundred and fifteen cases with advanced primary hepatic carcinoma were divided into 5 groups by accepting different chemotherapy： the groups of interventional-chemotherapy （group A, 40 cases）, whole body hyperthermia combined with chemotherapy （group B, 16 cases）, only chemotherapy （group C, 9 cases）, local heat chemotherapy （group D, 26 cases）, symptomatic supportive （group E, 24 cases） for comparing response rate （RR） and survival time between each other. Results The RR in group A,B,C were 30.5 % （12/40）, 12.5 % （2/16）, 11.1 % （1/9） respectively, and there was no significant difference among three groups （P〉0.05）. The mid-survival time of five groups were 7.7, 9.2, 7.9, 6.0, 4.7 months, and there was significant difference between group B and group E （P〈0.05）. The 0.5-, 1-, 2-year survival rate in group B were higher than those in group E with significant difference （81.2%vs. 29.1%, 37.5%vs. 12.5%, 12.5%vs. 0, all P〈0.05）. Conclusions The RR of only routine chemotherapy is low, while the RR of interventional-chemotherapy and local heat chemotherapy is high with non-prolonged survival time. Whole body hyperthermia combined with chemotherapy have active effects in helping to improve the efficacy and prolong the survival time in retreatment patients with advanced hepatic tumor.