XELOX方案治疗晚期原发性肝癌的效果及对血清肿瘤标志物水平的影响

目的 探讨奥沙利铂+卡培他滨(XELOX)方案治疗晚期原发性肝癌的临床效果及对血清肿瘤标志物的影响.方法 收集2009年1月-2013年1月78例晚期原发性肝癌患者的临床资料,按化疗方案分为XELOX组(n=40)与FOLFOX组(n=38,奥沙利铂+亚叶酸钙+5-氟尿嘧啶),比较两组化疗效果,记录化疗前后血清甲胎蛋白(AFP)、癌胚抗原(CEA)、组织多肽抗原(TPA)、糖链抗原(CA199)等肿瘤标志物水平的变化,统计化疗不良反应,比较两组生存质量.结果 两组总缓解率比较差异无统计学意义(P＞0.05).两组化疗后AFP、CEA、TPA和CA199均低于化疗前(P＜0.05).XELOX组1～5级肝肾毒性和胃肠道反应、1～2级骨髓抑制发生率均低于FOLFOX组(P＜0.05).XELOX组中位疾病进展时间和无进展生存期长于FOLFOX组(P＜0.05).结论 采用XELOX方案治疗晚期原发性肝癌疗效肯定,且不良反应发生率低,安全性高,同时可改善远期生存质量.

Efficacy of XELOX Protocol in Treatment of Advanced Primary Liver Cancer and Its Effect on Levels of Serum Tumor Markers

Objective To investigate efficacy of Oxaliplatin + Capecitabine (XELOX) chemotherapy in treatment of advanced primary liver cancer and its effect on levels of serum tumor markers.Methods Clinical data of 78 patients with advanced primary liver cancer between January 2009 and January 2013 was retrospectively analyzed.The patients were divided into XELOX group (n =40) and FOLFOX group (Oxaliplatin + Calcium Folinate + 5-Fluorouracil,n =38) according to chemotherapy protocol.In two groups,chemotherapy effect was compared;changes of tumor markers levels such as serum alpha fetoprotein (AFP),carcinoembryonic antigen (CEA),tissue polypeptide antigen (TPA)and carbohydrate antigen (CA199) before and after chemotherapy were recorded;adverse reactions of chemotherapy were statistically analyzed,and quality of life was compared.Results There was no significant difference in the total remission rate between the two groups (P ＞ 0.05).After treatment,AFP,CEA,TPA and CA199 levels were significantly lower than those before chemotherapy in the two groups (P ＜ 0.05).In XELOX group,incidence rates of 1-5 grade hepatic and renal toxicity and gastrointestinal reactions and 1-2 grade bone marrow suppression were significantly lower than those in FOLFOX group (P ＜ 0.05);time to progression (TTP) and progression-free survival (PFS) were significantly longer than those in FOLFOX group (P ＜ 0.05).Conclusion XELOX chemotherapy is effective in treatment of patients with advanced primary liver cancer with lower incidence rate of adverse reaction and good safety,and it can improve longterm survival quality of patients.