替吉奥联合经肝动脉化疗栓塞治疗中晚期肝细胞癌的疗效观察

目的对比观察经肝动脉栓塞化疗(TACE)单用或联合替吉奥治疗中晚期肝细胞癌(HCC)的疗效。方法将2009年8月-2010年10月本院收治的无法手术切除的中晚期HCC患者60例随机分为2组,每组30例。治疗组采用TACE联合替吉奥口服,对照组仅行TACE。观察2组的有效率、疾病控制率、生存率以及不良反应情况。计数资料采用χ2检验;生存分析运用Logrank检验。结果有效率:治疗组63.3%,对照组33.3%,差异有统计学意义(χ2=5.406,P=0.020);疾病控制率:治疗组86.7%,对照组43.3%,差异有统计学意义(χ2=12.308,P=0.000)。1年生存率:治疗组77.3%,对照组51.5%,差异有统计学意义(χ2=4.593,P=0.032);2年生存率:治疗组34.8%,对照组10.4%,差异有统计学意义(χ2=4.812,P=0.028)。治疗组、对照组不良反应轻微,主要是恶心呕吐、腹泻和骨髓抑制,为1、2级,对症治疗可缓解,两组比较差异无统计学意义(P0.05)。结论替吉奥联合TACE术对中晚期HCC有一定的治疗价值,值得进一步探讨。

Clinical effect of transcatheter arterial chemoembolization combined with tegafur,gimeracii, and oteracil potassium in treatment of advanced hepatocellular carcinoma

Objective To evaluate the clinical effect of transcatheter arterial chemoembolization （TACE） alone or combined with tegafur, gimeracil, and oteracil potassium （ S - 1 ） in the treatment of advanced hepatoeellular carcinoma （HCC）. Methods Sixty patients with un- resectable advanced HCC, who were admitted to our hospital from August 2009 to October 2010, were randomly divided into treatment group （ n = 30） and control group （ n = 30）. The treatment group was treated with TACE combined with oral S - 1, and the control group with TA- CE alone. The response rates, disease control rates, survival rates, and adverse reactions of both groups were evaluated. Categorical data were analyzed by chi - square test ; survival analysis was performed by Log - rank test. Results Compared with the control group, the treat- ment group had a significantly higher response rate （63.3 % vs 33.3 % , X2 = 5. 406, P = 0. 020） , a significantly higher disease control rate （ 86.7 % vs 43.3%, X2 = 12. 308, P = 0. 000）, a significantly higher 1 - year survival rate （77.3% vs 51.5 % , X2 = 4. 593, P = 0.032 ） , and a significantly higher 2 - year survival rate （ 34.8% vs 10.4% ,X2 = 4. 812, P = 0. 028 ）. Mild adverse reactions （ grade I or lI ） were seen in the two groups, including nausea, vomiting, diarrhea, and bone marrow suppression. These adverse reactions could he reduced by symptomatic treatment and showed no significant differences between the two groups （ P 〉 0.05 ）. Conclusion The combination therapy with S - 1 plus TACE is effective in the treatment of advanced HCC and is worth further study.