替吉奥联合肝动脉灌注化疗栓塞术治疗中晚期肝细胞癌临床分析

Effect of tegefur gimeracil oteracil combined with transcatheter arterial chemoembolization on advanced hepatocellular carcinoma

目的探讨替吉奥联合肝动脉灌注化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗中晚期肝细胞癌(hepatocellular carcinoma,HCC)的临床疗效及安全性。方法中晚期HCC患者47例随机分为观察组23例和对照组24例;观察组采用TACE+替吉奥口服治疗,对照组采用TACE治疗;观察2组治疗有效率、疾病控制率、生存率及不良反应发生情况。结果观察组治疗有效率(65.22%)、疾病控制率(86.96%)及12、24个月生存率(78.26%、34.78%)均高于对照组(33.33%、50.00%、50.00%、8.33%)(P<0.05);2组不良反应轻微,均未出现Ⅳ度毒性反应,观察组腹痛(69.6%)、恶心(65.2%)、呕吐(43.5%)、发热(73.9%)、血细胞下降(13.0%)、肝功能损伤(8.7%)及外周神经毒性反应(4.3%)发生率与对照组(70.8%、58.3%、41.7%、75.0%、12.5%、8.3%、4.2%)比较差异均无统计学意义(P>0.05)。结论替吉奥联合TACE治疗中晚期HCC疗效确切,安全。

Objective To explore the clinical effect and safety of oral tegefur gimeracil oteracil combined with transeatheter arterial chemoembolization （TACE） in the treatment of advanced hepatocellular carcinoma （HCC）. Methods Forty-seven patients with advanced HCC were randomly divided into observation group （n = 23） receiving TACE combined with oral administration of tegefur gimeracil oteracil and control group （n= 24） receiving TACE alone. The effective rate, disease control rate, survival and adverse reactions were observed. Results The effective rate （65.22%）, diseases control rate （86. 96%） and 24- and 48-month survival rates （78. 26%, 34. 78%） in observation group were significantly higher than those in control group （33. 33%, 50. 00%, 50. 00%, 8. 33%） （P〈0.05）. The adverse reactions were mild in both two groups, with no degree Ⅳ toxicity. There were no significant differences in the incidences of abdominal pain （69.6% vs 70.8%）, nausea （65.2% vs 58.3%）, vomiting （43.5% vs 41.7%）, fever （73.9% vs 75.0%）, beucopenia （13.0% vs 12.5%）, liver function injury （8.7% vs 8.3%） and peripheral neurotoxicity （4.3% vs 4. 2%） between observation group and control group （P〉0.05）. Conclusion For advanced HCC, oral administration of tegefur gimeracil oteracil combined with TACE is effective and safe.