经皮肝射频消融术联合经导管肝动脉灌注化疗治疗晚期结直肠癌多发肝转移瘤患者的效果

Effects of percutaneous radiofrequency ablation of live combined with transcatheter hepatic arterial infusion chemotherapy in treatment of patients with advanced colorectal cancer with multiple liver metastases

目的:观察经皮肝射频消融术联合经导管肝动脉灌注化疗治疗晚期结直肠癌(CRC)多发肝转移瘤患者的效果。方法:回顾性分析2017年1月至2018年1月该院收治的71例晚期CRC多发肝转移瘤患者作为研究对象,按治疗方法不同将其分为观察组36例与对照组35例。对照组采用经导管肝动脉灌注化疗治疗,观察组在对照组基础上联合经皮肝射频消融术治疗,比较两组客观缓解率、治疗前后肿瘤标志物指标[癌胚抗原(CEA)、糖类抗原19-9(CA19-9)]水平、肝功能指标[丙氨酸氨基转移酶(ALT)与天门冬氨酸氨基转移酶(AST)]水平、无进展生存时间(PFS)和不良反应发生率。结果:观察组客观缓解率为58.33%,高于对照组的34.29%,差异有统计学意义(P<0.05);治疗后,观察组CEA和CA19-9水平低于对照组,差异有统计学意义(P<0.05);观察组ALT和AST水平低于对照组,差异有统计学意义(P<0.05);观察组PFS长于对照组,差异有统计学意义(P<0.05);两组恶心、腹泻、骨髓抑制神经毒性、手足综合征发生率比较,差异均无统计学意义(P>0.05)。结论:经皮肝射频消融术联合经导管肝动脉灌注化疗治疗晚期CRC多发肝转移瘤患者可提高客观缓解率,降低肿瘤标志物指标水平和肝功能指标水平,以及延长PFS,其效果优于单纯经导管肝动脉灌注化疗。

Objective:To observe effects of percutaneous radiofrequency ablation of live combined with transcatheter hepatic arterial infusion chemotherapy in treatment of patients with advanced colorectal cancer(CRC)with multiple liver metastases.Methods:71 patients with advanced CRC with multiple liver metastases admitted to the hospital from January 2017 to January 2018 were selected as the subjects and retrospectively analyzed.According to different treatment methods,they were divided into observation group(36 cases)and control group(35 cases).The control group was treated with transcatheter hepatic arterial infusion chemotherapy,while the observation group was treated with percutaneous radiofrequency ablation on the basis of that of the control group.The objective remission rate,the levels of tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)],the levels of liver function indexes[alanine aminotransferase(ALT)and aspartate aminotransferase(AST)],the progression-free survival time(PFS)and incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The objective response rate in the observation group was 58.33%,which was higher than 34.29%in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of CEA and CA19-9 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of ALT and AST in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The PFS of the observation group was longer than that of the control group,and the difference was statistically significant(P<0.05).However,there were no significant differences in the incidences of nausea,diarrhea,myelosuppressive neurotoxicity,and hand-foot syndrome between the two groups(P>0.05).Conclusions:Percutaneous radiofrequency ablation of liver combined with transcatheter hepatic arterial infusion chemotherapy in the treatment of the patients with advanced CRC with multiple liver metastases can improve the objective remission rate,reduce the levels of tumor markers and liver function indicators,and prolong PFS.Moreover,it is superior to single transcatheter hepatic artery infusion chemotherapy.