TACE联合塞来昔布和醋酸奥曲肽对中期及进展期肝癌疗效及预后的影响

Effects of TACE combined with celecoxib and octreotide acetate on efficacy and prognosis of intermediate and advanced hepatocellular carcinoma

目的探讨肝动脉化疗栓塞术(TACE)联合塞来昔布和醋酸奥曲肽对中期及进展期肝癌疗效及预后的影响。方法回顾性分析113例巴塞罗那分期(BCLC)B、C级肝癌患者的临床资料,根据治疗方式将其分为TACE组(A组,n=24)、TACE+塞来昔布组(B组,n=30)、TACE+醋酸奥曲肽组(C组,n=27)、TACE+塞来昔布+醋酸奥曲肽组(D组,n=32)。比较各组患者治疗后肿瘤控制、生存率及不良反应情况。结果治疗后6个月,A、B、C、D组患者疾病控制率(DCR)分别为45.83%、50.00%、51.85%、78.12%,A、B、C组患者DCR比较差异无统计学意义(P>0.05),D组患者DCR明显高于A、B、C组,差异均有统计学意义(P<0.05)。D组患者24、36个月生存率分别为40.63%、25.00%,明显高于A组(12.50%、4.17%)、B组(20.00%、6.67%)、C组(18.82%、7.41%),差异均有统计学意义(P<0.05);D组总生存期为(20.23±7.71)个月,明显长于A、B、C组[(12.00±4.52)、(14.24±6.76)、(14.60±5.90)个月],差异均有统计学意义(P<0.05);而A、B、C组组间上述指标比较差异均无统计学意义(P>0.05)。4组患者不良反应比较,差异均无统计学意义(P>0.05)。结论TACE联合塞来昔布及醋酸奥曲肽治疗中期及进展期肝癌患者,可有效改善患者肿瘤控制效果,并延长患者的生存时间,且不良反应增加不明显。

Objective To explore the effects of transcatheter arterial chemoembolization(TACE)combined with celecoxib and octreotide acetate on the efficacy and prognosis of intermediate and advanced hepatocellular carcinoma(HCC).Methods The retrospective analysis was performed on the clinical data in 113 patients with BCLC stage B or C HCC,the patients were divided into the TACE group(group A,n=24),TACE+celecoxib group(group B,n=30),the TACE+octreotide acetate group(group C,n=27),and the TACE+celecoxib+octreotide acetate group(group D,n=32).The tumor control,survival and adverse reactions were compared among various groups.Results The disease control rates(DCR)after 6-month treatment in the group A,B,C and D were 45.83%,50.00%,51.85%and 78.12%respectively;DCR had no statistical difference among the group A,B and C(P>0.05).DCR in the group D was significantly higher than that in the group A,B and C,and the difference was statistically significant(P<0.05).The 24-month,36-month survival rates in the group D were 40.63%and 25.00%respectively,which were significantly higher than 12.50%and 4.17%in the group A,20.00%and 6.67%in the group B,18.82%and 7.41%in the group C,and the differences were statistically significant(P<0.05);the total survival period in the group D was(20.23±7.71)months,which was significantly higher than(12.00±4.52),(14.24±6.76),(14.60±5.90)months in the group A,B and C,and the differences were statistically significant(P<0.05).But the above indicators had no statistical difference among the group A,B and C(P>0.05).There was no statistical significance in adverse reactions among 4 groups(P>0.05).Conclusion TACE combined with celecoxib and octreotide acetate in the treatment of the patients with intermediate and advanced HCC can effectively improve the tumor control effect and prolong the patient′s survival time,moreover the increase of adverse reactions is unobvious.