替吉奥治疗原发性肝癌根治术后循环肿瘤细胞阳性患者的效果评价

Efficacy of tegafur in patients with positive circulating tumor cells after radical resection for primary hepatocellular cancer

目的探讨替吉奥治疗原发性肝癌(PHC)根治术后循环肿瘤细胞(CTC)阳性患者的治疗效果。方法选取2016年4月至2017年6月间上海复旦大学附属中山医院青浦分院收治的86例PHC术后CTC阳性患者,采用随机数表法分为治疗组和对照组,每组43例。采用随机、双盲和安慰剂对照的方法进行研究,治疗组患者口服替吉奥治疗,对照组患者口服安慰剂治疗比较两组患者的不良反应、CTC数目变化及术后肿瘤复发时间。结果治疗组患者共出现8例不良反应,包括肝功能损伤3例、骨髓抑制2例和消化道反应3例,使用药物治疗后症状好转。治疗前,两组患者CTC数目比较,差异无统计学意义(P>0.05)。治疗后3个月、6个月和12个月,对照组患者CTC数均大于治疗组患者,差异均有统计学意义(均P<0.05)。治疗组患者肝癌复发时间和病情进展时间均长于对照组患者,差异均有统计学意义(均P<0.05)。结论使用替吉奥治疗PHC根治术后CTC阳性患者,能降低CTC数目,抑制肿瘤复发,延缓病程进展。

Objective To evaluate the therapeutic efficacy of tegafur in the treatment of patients with circulating tumor cells(CTC)after radical resection of primary hepatocellular cancer(PHC).Methods Eighty-six patients with positive circulating tumor cells(CTC)after PHC were enrolled at Shanghai Fudan University Affiliated Zhngshan Hospital Qingpu Branch from April 2016 to June 2017.They were randomly divided into a treatment group and a control group with 43 patients in each group.A blind,placebo-controlled approach was performed.The treatment group received oral tegafur.The control group was given placebo orally.The adverse reactions,the number of CTCs,and the time to tumor recurrence were observed.Results Adverse reactions occurred in 8 patients,hepatic dysfunction occurred in 3 patinets,myelosuppression occurred in 2 patients and gastrointestinal dysfunction occurred in 3 patients in the treatment group,and the symptoms improved after use of drugs.There was no significant difference in the number of CTCs between the control group and the treatment group before the treatment(P>0.05).At 3,6 and 12 months after the treatment,CTCs were significantly greater in the control group than in the treatment group(P<0.05).Time to tumor recurrence and disease progression was longer in the treatment group than in the control group(all P<0.05).Conclusion The use of tegafur in the treatment of patients with CTC after radical resection of PHC can significantly reduce the number of CTCs,and delay the time to tumor recurrence and the progression of disease.