奥沙利铂、氟尿嘧啶、吡柔比星方案治疗中晚期肝癌的疗效与生存分析

The efficacy of combined chemotherapy with oxaliplatin,fluorouracil and pirarubicin in the treatment of advanced primary liver cancer and survival analysis

目的探讨奥沙利铂、氟尿嘧啶、吡柔比星方案治疗中晚期肝癌的临床疗效及对患者生存情况的影响。方法根据治疗方法的不同将108例中晚期肝癌患者分为经导管动脉栓塞(TAE)组和经皮肝动脉化疗栓塞术(TACE)组,各54例。TAE组患者接受TAE术治疗,TACE组接受奥沙利铂、氟尿嘧啶、吡柔比星方案灌注TACE术治疗。观察两组患者治疗8周后的临床疗效及治疗前后的血清学指标和免疫功能指标,比较两组患者的无疾病进展生存期(PFS)和总生存期(OS)。结果 TACE组患者的总有效率和疾病控制率均高于TAE组患者(P<0.05)。TACE组患者的临床疗效明显优于TAE组患者(P<0.01)。两组患者治疗后的CD3^+、CD4^+水平及CD4^+/CD8^+均高于本组治疗前,CD8^+水平均低于本组治疗前(P<0.05)。治疗后,TACE组患者的CD3^+、CD4^+水平及CD4^+/CD8^+均明显高于TAE组,CD8^+水平均明显低于TAE组(P<0.01)。两组患者的PFS和OS比较,差异均有统计学意义(P<0.01)。结论奥沙利铂、氟尿嘧啶、吡柔比星灌注TACE治疗能够提高中晚期原发性肝癌的临床疗效,改善患者的血清学指标和免疫功能,延长患者的生存时间。

Objective To observe the clinical efficacy of combination chemotherapy with oxaliplatin,fluorouracil and pirarubicin in the treatment of advanced primary liver cancer(PLC) and to assess the survival of patients.Method According to different therapies administered,108 patients with advanced PLC were included in the study as transarterial embolization(TAE) group and transcatheter arterial chemoembolization(TACE) group,with 54 cases in each.TAE group was treated with transarterial embolization while the TACE group was administered with combination therapy involving oxaliplatin,fluorouracil and pirarubicin for TACE.To observe the clinical efficacy of the two groups of patients after 8 weeks of treatment,as well as the serological indicators and immune function indicators before and after treatment.The progression-free survival(PFS) time and overall survival(OS) time were compared between the two groups.Result The overall response rate and the disease control rate were higher in TACE group compared to TAE group(P<0.05),with significantly better clinical efficacy observed in TACE group versus TAE group(P<0.01).The CD3^+,CD4^+ levels and CD4^+/CD8^+ in both groups post treatment were increased significantly,with decreased CD8^+ level noted compared to that before treatment(P<0.05).Additionally,the level of CD3^+,CD4^+ levels and CD4^+/CD8^+ were higher,and the level of CD8^+ was reduced in TACE group than in TAE group(P<0.01).The PFS and OS in both groups improved significantly after treatment(P<0.01).Conclusion TACE with hepatic infusion of oxaliplatin,fluorouracil and pirarubicin significantly improves the clinical efficacy for patients with advanced hepatocellular carcinoma,improving the serological indexes and immune function,with prolonged survival time.