雷替曲塞与氟尿嘧啶对不可切除肝癌患者的疗效观察

Comparison of therapeutic efficacy of raltitrexed versus fluorouracil on unresectable primary liver carcinoma

目的观察雷替曲塞与氟尿嘧啶分别联合奥沙利铂及表柔比星经导管肝动脉化疗栓塞术(TACE)治疗不可切除原发性肝癌患者的临床效果。方法回顾性收集2016年1月至2020年3月行TACE治疗的108例Ⅱb~Ⅲa期原发性肝癌患者根据用药不同分为2组,观察组56例和对照组52例。观察组给予雷替曲塞联合奥沙利铂及表柔比星行TACE治疗,对照组给予氟尿嘧啶联合奥沙利铂及表柔比星行TACE治疗。术后3 d、7 d复查血常规及肝肾功,4~6周复查腹部增强CT或MRI。根据改良实体瘤疗效评价标准(mRECIST)[9]评估治疗效果。2组患者于术后4~6周评估疗效。结果观察组CR 4例、PR 26例、SD 16例、PD 10例,ORR 54%,DCR 82%;对照组CR 2例、PR 21例、SD 16例、PD 13例,ORR 46%,DCR 75%;2组ORR、DCR比较差异无统计学意义(P=0.365)。观察组和对照组的中位PFS(mPFS)分别为191 d和137 d,相差54 d,差异有统计学意义(P=0.005)。2组患者的不良反应差异无统计学意义(P>0.05)。结论雷替曲塞联合奥沙利铂及表柔比星经TACE治疗不可切除肝癌的疗效较氟尿嘧啶联合奥沙利铂及表柔比星行TACE治疗能改善患者预后。

Objective To observe the clinical effect of raltitrexed and fluorouracil combined with oxaliplatin and epirubicin on patients with unresectaable primary liver carcinoma undergoing transcatheter arterial chemoembolisation(TACE).Methods A total of 108 patients with stageⅡb~Ⅲa primary liver carcinoma who were treated with TACE from January 2016 to March 2020 were retrospectively recruited.They were assigned to the observation group(n=56)and the control group(n=52).Patients in the observation group were treated with raltitrexed combined with oxaliplantin and epirubicin by TACE,and those in the control group were treated with fluorouracil combined with oxaliplantin and epirubicin by TACE.The blood routine test,liver function and renal function were detected at 3 and 7 days postoperatvely.The enhanced computed tomography(CT)/magnetic resonance imaging(MRI)scan of abdomen were re-examined in 4~6 weeks after surgery.The therapeutic effect was evaluated by modified Response Evaluation Criteria in Solid Tumors(mRECIST).Results In the observation group,complete remission(CR),partial remission(PR),stable disease(SD)and progressive disease(PD)were achieved in 4,26,16 and 10 cases,respectively,with the overall response rate(ORR)and disease control rate(DCR)of 54%and 82%,respectively.In the control group,CR,PR,SD and PD were achieved in 2,21,16 and 13 cases,respectively,with the ORR and DCR of 46%and 75%,respectively.There were no significant differences in ORR and DCR between two groups(P=0.365).The median progression-free survival(mPFS)in the observation group was significanty longer than that in the control group(191 days vs 137 days,P=0.005).There was no significant difference in the incidence of adverse events between two groups(P>0.05).Conclusion Raltitrexed combined with oxaliplantin and epirubicin by TACE improves the prognosis of patients with unresectable primary liver carcinoma compared with that of fluorouracil combined with oxaliplantin and epirubicin.