肝动脉化疗栓塞术后应用奥沙利铂联合替吉奥治疗晚期原发性肝癌的临床观察

Clinical Observation of Oxaliplatin Combined with Tegafur in the Treatment of Advanced Primary Hepatic Carcinoma after Transcatheter Arterial Chemoembolization

目的:观察肝动脉化疗栓塞术后应用奥沙利铂联合替吉奥治疗晚期原发性肝癌的疗效和安全性。方法:选取我院2011年4月-2013年4月的晚期原发性肝癌患者120例,按照随机数字表法分为对照组和观察组,各60例。两组患者均行肝动脉化疗栓塞术。对照组患者术后给予奥沙利铂注射液0.08 g/m^2,经导管动脉泵注,4 h内泵注完毕;观察组患者在对照组基础上给予替吉奥胶囊40 mg/m^2,po,bid。两组患者均治疗4个月。观察两组患者临床疗效、肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)和直接胆红素(DBIL)]和甲胎蛋白(AFP)水平,记录治疗过程中不良反应发生情况以及随访1、2、3年的生存率。结果:治疗前,两组患者肝功能指标、AFP水平比较,差异均无统计学意义(P>0.05)。治疗后,观察组患者的疾病控制率(78.33%)和临床受益率(93.33%)均明显高于对照组(48.33%和71.67%),差异均有统计学意义(P<0.05);两组患者ALT、AST、TBIL和DBIL水平均明显升高,但观察组明显低于对照组,差异均有统计学意义(P<0.05);两组患者AFP水平明显降低,且观察组明显低于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。观察组患者随访1、2、3年的生存率均明显高于对照组,差异均有统计学意义(P<0.05)。结论:肝动脉化疗栓塞术后应用奥沙利铂联合替吉奥治疗晚期原发性肝癌患者疗效较好,且安全性好。

OBJECTIVE:To observe therapeutic efficacy and safety of oxaliplatin combined with tegafur in the treatment of advanced primary hepatic carcinoma after transcatheter arterial chemoembolization(TACE).METHODS:120patients with advanced primary hepatic carcinoma were selected from our hospital during Apr.2011-Apr.2013,and then divided into control group and observation group according to random number table,with60cases in each group.Both groups received TACE.Control group was given Oxaliplatin injection0.08g/m2after surgery via catheter arterial puming,within4h;observation group was additionally given Tegafur capsules40mg/m2,po,bid,on the basis of control group.Both group received treatment for4months.Clinical efficacy,hepatic function indexes[ALT,AST,TBIL,DBIL]and alpha-fetoprotein(AFP)level were observed in2groups;the occurrence of ADR during treatment was recorded as well as1-year,2-year,3-year follow-up survival rates.RESULTS:Before treatment,there was no statistical significance in hepatic function indexes and AFP(P>0.05).After treatment,disease control rate(78.33%)and clinical benefit rate(93.33%)of observation group were significantly higher than those of control group(48.335,71.67%),with statistical significance(P<0.05).The levels of ALT,AST,TBIL and DBIL in2groups were increased significantly,while the observation group was significantly lower than the control group,with statistical significance(P<0.05).AFP level of2groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance(P<0.05).There was no statistical significance in the incidence of ADR between2groups(P>0.05).1-year,2-year,3-year follow-up survival rates of observation group were significant higher than control group,with statistical significance(P<0.05).CONCLUSIONS:Oxaliplatin combined with tegafur is effective for advanced primary hepatic carcinoma after TACE with good safety.