两种不同化疗方案联合TACE治疗不可切除肝癌的临床疗效与安全性对比

Comparison of Clinical Efficacy and Safety of Two Different Chemotherapy Regimens Combined with TACE in the Treatment of Patients with Unresectable Hepatocellular Carcinoma

目的探讨两种不同化疗方案联合经导管肝动脉化疗栓塞(TACE)治疗不可切除肝癌的临床疗效和安全性。方法将本院介入科治疗的65例原发性肝癌患者按照奇偶数法分为观察组和对照组进行研究。两组患者均行TACE术治疗,其中观察组给予雷替曲塞联合奥沙利铂化疗,雷替曲塞栓塞治疗;对照组给予5-氟尿嘧啶联合奥沙利铂化疗,表柔比星栓塞治疗。一个月为一个疗程,治疗后一个月评价疗效。观察两组治疗的临床疗效和不良反应发生情况。结果治疗后观察组完全缓解率(21.21%)、总有效率(72.73%)、总控制率(90.91%)、血清甲胎蛋白(AFP)下降率(48.18%)均显著高于对照组(9.38%、56.26%、81.25%、25.00%,P<0.05)。两组患者发热、恶心呕吐、疼痛、白细胞减少及肝功能损害等不良反应发生率比较差异无显著性(P<0.05)。观察组患者的两年期生存率(57.58%)明显高于对照组(40.63%,P<0.05),观察组治疗方案远期疗效更优。结论雷替曲塞与奥沙利铂联合TACE治疗不可切除肝癌的临床疗效较好,不良反应可耐受,值得临床进一步推广。

Abstract： Objective To investigate the clinical efficacy and safety of two different chemotherapy regimens combined with transcatheter arterial chemoembolization （TACE） for unresectable hepatocellular carcinoma. Methods From January 2012 to March 2014, sixty-five patients with hepatocellular carcinoma received in our department were divided into the observation group and control group by odd even method.All of the patients were treated with TACE.The observation group was given raltitrexed and oxaliplatin combined with TACE treatment, and the control group was treated with 5-fluorouracil plus oxaliplatin combined with TACE treatment.With one month as a course of treatment,curative and side effects were evaluated a month later.The efficacy of treatment and side effects were compared between the two groups. Results After interventional therapy, complete remission rate （ 21.21% ）, total effective rate （ 72.73 % ） and total control rate （ 90.91% ） in the observation group were significantly higher than those in the control group of 9.38%, 56.26% and 81.25% （P〈0.05）. The decreased rate of alpha fetal protein （AFP） in the observation group was 48.18% ,which was significantly higher than that in the control group of 25.00% （P〈0.05）.For the long-term efficacy, two-year survival rate of the patients in the observation group was 57.58%, which was significantly higher than that of the control group （40.63%） （P〈0.05）. Conclusion Raltitrexed combined with oxaliplatin is effective and safe for patients with unresectable hepatocellular carcinoma, and it＇ s worthy of further clinical promotion.