老年中晚期肝癌患者D-TACE治疗中血清标志物变化及疾病控制率(DCR)、局部有效率(ORR)研究

Study on Serum Biomarkers Changes,Disease Control Rate(DCR),and Local Response Rate(ORR)of Elderly Advanced Liver Cancer Patients Treated with D-TACE

目的 分析老年中晚期原发性肝癌(HCC)患者载药微球-肝动脉化疗栓塞(D-TACE)治疗中血清标志物变化及疾病控制率(DCR)、局部有效率(ORR)。方法 选定本院2017年1月-2019年1月住院的26例老年中晚期HCC患者,以随机法将其分组(每组各13例),对比组给予碘化油经动脉化疗栓塞术(C-TACE)治疗,观察组给予D-TACE治疗,比较两组DCR、ORR、肝功能指标、血清肿瘤标志物、并发症总发生率、两年内生存率。结果 观察组DCR、ORR均高于对比组(P<0.05)。观察组治疗后血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)均高于对比组(P<0.05)。观察组治疗后血清糖类抗原199(CA199)、癌胚抗原(CEA)、甲胎蛋白(AFP)均低于对比组(P<0.05)。观察组并发症总发生率与对比组比较无统计学意义(P>0.05)。观察组两年内生存率高于对比组(P<0.05)。结论 D-TACE与C-TACE在治疗老年中晚期HCC方面安全性相当,但D-TACE可有效提高DCR、ORR,改善肝功能,抑制血清肿瘤标志物释放,提高患者远期生存率。

Objective To analyze serum biomarkers changes,disease control rate(DCR),and local response rate(ORR)during drug loaded microspheres hepatic artery chemoembolization(D-TACE)treatment for elderly patients with advanced primary liver cancer(HCC).Methods The paper chose 26 elderly patients with advanced HCC admitted to our hospital from January 2017 to January 2019,and divided them into groups(n=13 in each group)randomly.Control group was treated with iodinated oil transarterial chemoembolization(C-TACE),while observation group with D-TACE.DCR,ORR,liver function indicators,serum tumor markers,total incidence of complications,and 2-year survival rate were compared between two groups.Results DCR and ORR in observation group was higher than control group,P<0.05.After treatment,serum levels of alanine transaminase(ALT),aspartate transaminase(AST)and total bilirubin(TBIL)in observation group were higher than control group(P<0.05).After treatment,levels of serum carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA)and alpha fetoprotein(AFP)in observation group were lower than control group(P<0.05).Total complications incidence comparison between observation group and control group showedP>0.05.the 2-year survival rate of observation group(76.92%)was higher than control group(30.77%),P<0.05.Conclusion D-TACE and C-TACE is equally safe in treatment of elderly patients with advanced HCC,but D-TACE can improve DCR and ORR,liver function effectively,inhibit the release of serum tumor markers,and improve long-term survival rate of patients.