替吉奥联合奥沙利铂辅助射频消融术治疗直肠癌根治术后肝转移的临床观察

Clinical Observation of Tegafur,Gimeracil and Oteracil Potassium Combined with Oxaliplatin Assisting with Radiofrequency Ablation in the Treatment of Liver Metastases after Radical Operation of Rectal Cancer

目的:观察替吉奥联合奥沙利铂辅助射频消融(RFA)术治疗直肠癌根治术后肝转移的疗效和安全性。方法:130例直肠癌根治术后肝转移患者随机分为对照组(65例)和观察组(65例)。RFA术后1周,对照组患者给予奥沙利铂注射液130 mg/m^2,d_1;观察组患者在对照组治疗的基础上给予替吉奥胶囊,连用14 d后停药7 d为1个周期。两组均以3周为1个周期,共治疗2个周期。观察两组患者的近期疗效,完全消融率、局部复发率、生存率及毒性反应发生情况。结果:观察组患者总缓解率、疾病控制率、完全消融率及随访1、2、3年生存率均显著高于对照组,局部复发率显著低于对照组,差异均有统计学意义(P<0.05)。两组患者毒性反应发生率比较,差异均无统计学意义(P>0.05)。结论:替吉奥联合奥沙利铂辅助RFA术治疗直肠癌根治术后肝转移的疗效显著,可延缓病情进展,降低局部复发率,延长生存时间,且未增加毒性反应的发生。

OBJECTIVE： To observe therapeutic efficacy and safety of tegafur, gimeracil and oteracil potassium combined with oxaliplatin assisting with radiofrequency ablation （RFA） in the treatment of liver metastases after radical operation of rectal cancer. METHODS： A total of 130 patients with liver metastases after radical operation of rectal cancer were randomly divided into control group and observation group, with 65 cases in each group. After RFA one week, control group was given Oxaliplatin injection 130 mg/m^2 intravenously, d1, more than 3 h. Observation group was additionally given Tegafur capsule, for consecutive 14 d, drug withdrawal of 7 d, as a treatment course. A treatment course lasted for 3 weeks, and both groups received 2 courses of treatment. Short-term efficacies of 2 groups were observed as well as complete ablation rate, local recurrence rate, survival rate and the occurrence of toxic reaction. RESULTS： The total remission rate, disease control rate, complete ablation rate, 1-year, 2-year and 3-year survival rates of observation group were significantly higher than those of control group, and local recurrence rate was significantly lower than control group, with statistical significance （P〈0.05）. There was no statistical significance in the incidence of toxic reaction between 2 groups （P〉0.05）. CONCLUSIONS： Tegafur, gimeracil and oteracil potas siucn combined with oxaliplatin assisting with RFA shows significant therapeutic efficacy for liver metastase after radical operation of rectal cancer, and can significantly delay disease progression, reduce local recurrence rate and prolong survival time, and does not increase the occurrence of toxic reaction.