脾多肽注射液联合经导管肝动脉化疗栓塞治疗中晚期原发性肝癌

Lienal polypeptide injection combined with transcatheter arterial chemoembolization for advanced primary liver cancer

目的探讨脾多肽注射液联合经导管肝动脉化疗栓塞(TACE)治疗中晚期原发性肝癌的临床疗效。方法选取2013年6月至2015年1月在我院接受治疗的中晚期原发性肝癌患者60例,随机分为脾多肽组(脾多肽注射液联合TACE)和对照组(单纯TACE),每组30例。评价并比较两组患者治疗前生活质量(KPS评分)、免疫功能及治疗结束后1个月的临床疗效(RECIST 1.1标准)、KPS评分、免疫功能,记录并比较两组患者的不良反应发生率和生存率。结果脾多肽组的客观有效率(完全缓解+部分缓解)为63.3%(19/30),对照组为33.3%(10/30),两组比较差异有统计学意义(P<0.05)。脾多肽组患者治疗后KPS改善较对照组明显,两组差异有统计学意义(P<0.05)。脾多肽组治疗后CD3^+、CD4^+、CD4^+/CD8^+比值较治疗前提高(P<0.05),而对照组免疫学指标在治疗前后无明显变化。脾多肽组患者的血液毒性和消化道反应等不良反应发生率低于对照组(P<0.05)。脾多肽组与对照组的1年生存率分别为53.3%、43.3%,差异无统计学意义(P>0.05);脾多肽组患者的2年生存率为40.0%,高于对照组的13.3%,差异有统计学意义(P<0.05)。结论脾多肽注射液联合TACE可提高中晚期原发性肝癌患者的临床疗效,延长患者生存期,提高患者的生活质量,并增加患者的免疫功能。

Objective To explore the clinical efficacy of lienal polypeptide injection combined with transcatheter arterial chemoembolization（TACE）for treatment of patients with advanced primary liver cancer.Methods A total of 60 patients with advanced primary liver cancer were enrolled from Jun.2013 to Jan.2015 in Eastern Hepatobiliary Surgery Hospital,and were divided randomly into treatment group（lienal polypeptide injection combined with TACE,n=30）and control group（TACE,n=30）.We observed the quality of life（KPS score）and immunity index of the patients in two groups before treatment and observed the clinical efficacy（RECIST 1.1criteria）,KPS score and immunity index after treatment for one month,then and recorded and compared the adverse effects and survival rates in two groups.Results The objective effective rate（complete remission and partial remission）was 63.3%（19/30）in treatment group and was33.3%（10/30）in control group,with significant difference between the two groups（P〈0.05）.The KPS score of treatment group was better than that of control group（P〈0.05）.In treatment group,the CD3^＋ and CD4^＋ lymphocytes and the ratio of CD4^＋ to CD8^＋ lymphocytes were significantly increased after the treatment（P〈0.05）,and they had no significant change in control group before and after treatment.The incidences of adverse reactions,such as hematological toxicity and gastrointestinal reactions in treatment group were significantly lower than those in the control group（P〈0.05）.There was no significant difference in one-year survival rate between treatment group（53.3%）and control group（43.3%,P〈0.05）,while the two-year survival rate of treatment group was significantly higher than that in the control group（40.0% vs 13.3%,P〈0.05）.Conclusion Lienal polypeptide injection combined with TACE can improve the clinical efficacy and survival rate of the patients with advanced primary liver cancer.