动脉微泵灌注奥沙利铂治疗结直肠癌术后肝转移

Arterial infusion of Oxaliplatin for treatment of liver metastases from colorectal cancer after surgery

目的探讨动脉微泵灌注奥沙利铂方案TACE治疗结直肠癌术后肝转移的有效性、安全性及其影响因素。方法回顾性分析68例经病理证实且接受至少2个疗程的动脉微泵灌注奥沙利铂方案TACE治疗的结直肠癌术后肝转移患者的资料。以TACE前是否曾接受全身静脉化疗分为A组(未化疗)和B组(已化疗)。随访患者生存时间,按实体瘤的疗效评价标准评价客观疗效,对比两组的不良反应。对影响生存时间的可能因素进行Cox回归分析。结果 68例患者中位生存期(OS)为18个月,中位无进展生存时间(PFS)为10个月。经治疗后完全缓解16例,部分缓解26例,稳定21例,进展5例;治疗有效率(RR)为61.76%(42/68)。两组RR、OS、PFS差异均无统计学意义(P均>0.05)。两组不良反应中程度≥Ⅰ级的发生率差异均无统计学意义(P均>0.05)。最终进入Cox回归模型的变量为肿瘤分化程度(P=0.003,风险比=2.202)。结论动脉微泵灌注奥沙利铂方案TACE治疗结直肠癌术后肝转移疗效确切,具有较高的客观有效率。

Objective To explore the effectiveness, safety and influencing factors of arterial infusion of oxaliplatin for the treatment of colorectal liver metastases after surgery. Methods Totally 68 colorectal liver metastases after surgery patients pathologically confirmed received at least two course of arterial infusion of oxaliplatin combined with TACE. According to postoperative intravenous chemotherapy, the patients were divided into group A （no chemotherapy） and group 13 （chemotherapy）. Survival time of patients were followed up. According to the efficacy of solid tumor evaluation criteria the objective effect was evaluated, the adverse reactions were compared between two groups. Cox regression analysis was performed to assess the possible factors influencing survival time. Results The median overall survival （OS） of all the 68 patients was 18 months, with complete remission 16 cases, partial remission 26 cases, stable diseasse 21 cases, stable diseasse 5 cases, the response rate （RR） was 61.76% （42/68）. The median progression-free survival （PFS） was 10 months. The RR, OS and PFS had no statistical difference （all P〉0.05）. The variables that eventually entered the Cox regression model were tumor differentiation （P=0. 003, hazard ratio=2. 202）. Conclusion Arterial infusion of oxaliplatin and TACE is effective in treating coloreetal liver metastases after surgery, with high objective response rate.