经肝动脉灌注榄香烯联合肝动脉化疗栓塞术治疗不可切除肝癌的疗效观察

Observation of curative effect of transarterial infusion of elemene combined with transcatheter arterial chemoembolization for unresectable liver cancer

目的:观察经肝动脉灌注榄香烯联合肝动脉化疗栓塞术(TACE)治疗不可切除肝癌的近期疗效及不良反应。方法:选取我院2015年1月至2016年10月收治的48例不可切除的肝癌患者,将其随机分为观察组24例和对照组24例,对照组给予TACE治疗(雷替曲塞3 mg/m~2、奥沙利铂100 mg/m~2、表柔比星40 mg/m~2),观察组给予肝动脉灌注榄香烯注射液(200~400 mg/m~2)+TACE治疗(雷替曲塞3 mg/m~2、奥沙利铂100 mg/m~2、表柔比星40 mg/m~2)。以上治疗每4~6周1次,末次随访时间为2018年10月31日。观察对比两组的治疗有效率(RR)、疾病控制率(DCR)、无进展生存期(PFS)及不良反应。结果:观察组和对照组的RR分别为66.67%、58.33%,DCR分别为87.50%、83.33%,差异无统计学意义(P>0.05)。两组平均PFS分别为(10.69±1.00)个月、(7.68±1.03)个月,差异具有统计学意义(P<0.05)。两组不良反应主要为腹痛、恶心、呕吐、骨髓抑制、发热、转氨酶升高等,两组间在发热、恶心、呕吐、骨髓抑制发生率的差异有统计学意义(P<0.05),在腹痛、转氨酶升高发生率的组间差异无统计学意义(P>0.05)。结论:经肝动脉灌注榄香烯联合TACE治疗不可切除肝癌安全可行,可减轻TACE术后不良反应,延长患者平均PFS。

Objective:To observe the short term efficacy and adverse reactions of transarterial infusion of elemene combined with transcatheter arterial chemoembolization for unresectable liver cancer.Methods:48 cases of patients with unresectable liver cancer in our hospital from January 2015 to October 2016,were randomly divided into observation group(24 cases)and control group(24 cases).Patients in control group were treated with transcatheter arterial chemoembolization(TACE)using raltitrexed(3 mg/m 2)combined with oxaliplatin(100 mg/m 2)and epirubicin(40 mg/m 2),while patients in observation group were treated with hepatic arterial infusion of elemene(200~400 mg/m 2)combined with TACE using raltitrexed(3 mg/m 2)combined with oxaliplatin(100 mg/m 2)and epirubicin(40 mg/m 2).Repeated treatment was given every 4~6 weeks.The end of the follow-up period was October 31,2018.The response rate(RR),disease control rate(DCR),progression free survival(PFS)and the adverse effects were assessed,and the results were compared between the two groups.Results:The RR of the observation group and control group were 66.67%and 58.33%respectively.The DCR of the observation group and control group were 87.50%and 83.33%respectively.Both the differences between the two groups were not statistically significant(P>0.05).The mean progression free survival of the observation group and control group were(10.69±1.00)months and(7.68±1.03)months respectively.And the difference was statistically significant(P<0.05).The adverse reactions in the two groups were mainly abdominal pain,nausea,vomiting,myelosuppression,fever and elevation of transaminase.There were statistically significant differences in the incidence of fever,nausea and vomiting,and myelosuppression between the two groups(P<0.05).There were not significant differences in the incidence of abdominal pain and transaminase elevation(P>0.05).Conclusion:Transarterial infusion of elemene combined with TACE for the treatment of unresectable liver cancer is safe and feasible,and can reduce the adverse reactions after TACE and prolong the average PFS.