奥沙利铂联合卡培他滨方案治疗中晚期PLC的疗效观察

Observation of Effects of Oxaliplatin Combined with Capecitabine in the Treatment of Primary Hepatic Carcinoma

目的观察奥沙利铂联合卡培他滨治疗中晚期原发性肝癌(PLC)的临床疗效和安全性。方法选取2012年8月至2015年7月我院收治的中晚期PLC患者90例为研究对象。对照组30例单用奥沙利铂(OXA)治疗,OXA 140 mg静脉滴注,d1、d15;亚叶酸钙片50 mg口服,d1~14。研究组60例采用OXA联合卡培他滨(CAP)方案治疗,在对照组基础上给予CAP1000 mg/次,口服,2次/d,d1~14。两组均每4周为1个疗程,每2个疗程评价客观疗效和毒副反应。分析两组6个月、1年总生存率及血清甲胎蛋白(AFP)水平变化。结果研究组疾病控制率(42.1%)显著高于对照组(13.3%)(χ2=3.54,P=0.03);研究组6个月(68.4%)、1年生存率(57.9%)均显著高于对照组(40.0%、26.7%)(χ2=3.62、4.96,P<0.05);研究组治疗后血清AFP水平[(96.8±21.9)μg·L-1]与对照组[(101.2±23.8)μg·L-1]比较并无明显差异(t=0.72,P>0.05);研究组毒副反应发生率(18.3%)显著低于对照组(53.3%)(χ2=5.89,P<0.01)。结论 OXA联合CAP治疗中晚期PLC患者的临床疗效较好,安全性高,并对老年患者及一般情况较差的患者有较好的耐受性。

Objective To investigate the curative effect and survival benefit of primary hepatic carcinoma in the treatment of oxaliplatin combined with capecitabine. Methods Selected 90 cases of advanced patients with PLC treated in our hospital from August 2012 to July 2015.60 patients treated with oxaliplatin combined with capecitabine as the research group and 30 patients underwent oxaliplatin treat- ment as the control group. The control group received Oxaliplatin 140 mg, ivgtt, dl, d15; calcium folinate tablets 50 mg, oral, d1 - 14. The research group underwent the capeeitabine 1000 mg/time, oral, twice per day, d1- 14 on the basis of the control group. Every 4 weeks for a course of treatment in the two groups. Evaluated the objective efficacy and toxicity after every two courses of treatment. Observed and ana- lyzed the 6 months survival rate, 1 year overall survival rate, and the changes of serum alpha （AFP） levels in the two groups. Results The disease control rate in the research group （42.1%） was higher than that of the control group （ χ2=3-54, P=0.03）; the 6 months survival rate （68.4%）, and 1 year overall survival rate （57.9%） were higher than those of the control group （40.0%, 26.7%） （ χ2=3-62, 4.96, P〈0.05）; the level of AFP after treatment in the research group [ （96.80 ＋ 21.96） μg.L-1 ] and the control group [ （101.23 ± 23.89） μg.L-1 ] showed no significant difference （t =0.72, P 〉 0.05）; the incidence rate of side effects in the research group （18.3%） was lower than that of the control group （53.3%） （ χ 2=5-89, P〈 0.01）. Conclusion OXA combined with CAP in the treatment of patients with advanced PLC has better clinical efficacy, less toxic and side effects, and has a better tolerance for elderly patients and patients with poor general condition.