肝动脉灌注联合吉西他滨化疗治疗进展期肝内胆管细胞癌的疗效分析

Efficacy analysis of hepatic arterial infusion in combination with intravenous gemcitabine chemotherapy for advanced intrahepatic cholangiocarcinoma

目的:探讨采用肝动脉灌注(HAI)结合吉西他滨全身化疗治疗进展期肝内胆管细胞癌(ICC)的临床效果。方法:选取79例具有可测量病灶的进展期ICC患者采用随机数字表法分为试验组(39例)与对照组(40例),试验组采取HAI(5-FU+顺铂)+吉西他滨静脉给药化疗,对照组采取吉西他滨+顺铂进行全身静脉化疗。两组患者均接受2个疗程治疗,1个月为1个疗程。结果:试验组与对照组的缓解率差异无统计学意义(38.46%vs.20.00%,P>0.05),但试验组获益率明显高于对照组(79.49%vs.60.00%,P<0.05);两组化疗后肿瘤标志物水平均较化疗前明显降低,但试验组的降低程度明显大于对照组(均P<0.05);试验组与对照组1、2年生存率差异无统计学意义(63.16%vs.39.47%;55.00%vs.22.50%,均P>0.05),但试验组患者的3年生存率明显高于对照组(23.68%vs.7.50%,P<0.05);两组患者化疗过程中各项毒副反应的发生率均无统计学从差异(均P>0.05)。结论:HAI结合吉西他滨全身静脉化疗治疗进展期ICC患者能取得较好的近期疗效,提高远期生存率。

Objective： To investigate the clinical efficacy of hepatic arterial infusion （HAl） of 5-fluorouracil （5-FU） and cisplatin combined with systemic intravenous chemotherapy ofgemcitabine in treatment of advanced intrahepatic cholangiocarcinoma （ICC）. Methods： Seventy-nine patients with advanced ICC and measurable lesions were enrolled and designated to study group （39 cases） and control group （40 cases） by use of a random number table. Patients in study group underwent HAl of 5-FU＋cisplatin combined with intravenous gemcitabine chemotherap）5 and those in control group underwent systemic intravenous chemotherapy of gemcitabine and cisplatin. Patients in either group received two repeated courses of treatment, with one month per course. Results： There was no statistical difference in response rate between study group and control group （38.46% vs. 20.00%, P〉0.05）, but the benefit rate in study group was significantly higher than that in control group （79.49% vs. 60.00%, P〈0.05）. The levels of tumor biomarkers were significantly decreased in both groups after treatment compared with their pretreatment levels, but their decreasing amplitudes were significantly greater in study group than those in control group （all P〈0.05）. q-he 1- and 2-year survival rates showed no statistical difference between study group and control group （63.16% vs. 39.47%; 55.00% vs. 22.50%, both P〉0.05）, but the 3-year survival rate in study group was significantly higher than that in control group （23.68% vs. 7.50%, P〈0.05）. There was no statistical difference in incidence of each toxic and adverse reaction during chemotherapy （all P〉0.05）. Conclusion： HA1 combined with systemic intravenous gemcitabine chemotherapy for advanced intrahepatic cholangiocarcinoma patients can achieve relatively good short-term effects and increased long-term survival.