中西医联合放化疗对原发性肝癌患者疗效及转移相关因子的影响

Effect of Combined Therapy of Chinese and Western Combined with Radiotherapy on the Patients With Primary Liver Cancer and its Metastasis Related Factors

目的探讨中西医联合放化疗治疗原发性肝癌临床疗效及其对相关转移因子的影响作用。方法选择于2010年1月~2013年1月在我院接受治疗的60例原发性肝癌患者,将其随机分为观察组和对照组,各30例。对照组行经导管动脉内化疗栓塞术(transarterial Chemoembolization,TACE)联合三维适形放疗(three dimensional conformal radiation therapy,3D-CRT),观察组在对照组基础上加用中药治疗。分别采用酶联免疫吸附法、RT-PCR法检测VEGF和COX-2基因表达治疗前后的动态变化,观察两组患者治疗效果。结果观察组治疗有效率76.67%较对照组43.33%显著提高(P<0.01)。观察组患者术后1年、2年和3年的存活率分别为76.67%(23/30)、66.67%(20/30)和50.00%(15/30),对照组患者术后1年、2年和3年的存活率分别为50.00%(15/30)、36.67%(11/30)和30.00%(9/30),随访1、2年时两组生存率差异有统计学意义(P<0.05),而3年存活率基本相当。治疗后观察组血清VEGF表达下调,对照组明显上调,组间比较差异有显著统计学意义(P<0.01);观察组COX-2阳性率显著降低(P<0.05)。结论中西医联合放化疗治疗原发性肝癌可获得满意疗效,增效作用与COX-2、VEGF的调控有关,且对1、2年生存率改善显著,使转移风险降低获益。

Objective To explore the clinical effect of combined treatment of traditional Chinese medicine and West-ern medicine combined with radiotherapy in the treatment of primary liver cancer and its effect on the metastasis factors. Methods The 60 cases of primary liver cancer from January 2010 to January 2013 were randomly divided into the observa-tion group and the control group, 30 cases in each group. The control group was treated by transcatheter arterial chemoem- bolization combined with three dimensional conformal radiotherapy,and the observation group was treated with traditional Chi-nese medicine on the basis of the control group. The dynamic changes of VEGF and COX-2 expression in the two groups were respectively detected by enzyme linked immunosorbent assay and RT-PCR method before and after treatment. The thera-peutic effect of the two groups were observed. Results The total effective rate in the observation group （76.67%） was signifi-cantly hgiher than that in the control group （43.33%） （P〈0.01）. The survival rate of patients in the observation group after 1 year,2 years and 3 years was 76.67% （23/30）,66.67% （20/30） and 50.00% （15/30）,respectively. While survival rate in the control group after 1 year,2 years and 3 years was 50.00% （15/30）,36.67% （11/30） and 30.00% （9/30）,respectively. The survival rates after 1 year and 2 years follow up were statistically significant （P〈0.05）, while the survival rate of 3-year were similar. After treatment, serum VEGF levels were down regulated while the levels in the observation group were significantly up regulated （P〈0.01）. After treatment, the positive rate of COX-2 in the observation group was significantly lower （P〈0.05）. Conclusion The combination of Chinese and Western medicine combined with radiotherapy and chemotherapy shows satisfying effects in the treatment of primary liver cancer. Its synergy effet is related to the regulation of COX-2 and VEGF, and it canimprove 1 -year and 2 -year survival rates and reduce the risk of metastasis.