草酸铂联合希罗达在原发性肝癌术后化疗中的临床应用

目的评估草酸铂联合希罗达在原发性肝癌术后化疗的有效性及安全性。方法对我院在2006年4月～2008年6月收治46例原性肝癌患者均在手术切除后接受化疗进行回顾性分析。其中27例接受以草酸铂和希罗达化疗方案的患者为治疗组,19例接受以5-氟尿嘧啶、丝裂霉素和阿霉素化疗方案的患者为对照组。参照RECIST标准对该方案疗效(CR、PR、SD、PD、ORR、OS和DFS)进行评估,按照抗癌药毒副反应的分度标准(WHO标准)评价疗效及毒副反应。结果 46例获得可评估客观疗效。在治疗组中:CR10例(37.04%),PR9例(33.33%),SD3例(11.11%),PD5例(18.52%);其毒副作用主要为外周神经毒性,但均可以耐受。对照组5例获得CR(26.32%)、2例PR(10.53%)、4例SD(21.05%)、8例PD(42.11%);毒副作用主要为不同程度的骨髓抑制、消化道毒性反应,对症治疗后可缓解。两组比较:CR、PR、SD、PD两组之间无显著差异,而治疗组在ORR(P=0.0355)和DFS(P=0.0004)方面表现出明显的优势。结论草酸铂和希罗达联合化疗方案在原发性肝癌术后化疗的疗效较高,安全性好,此化疗方案可能提高肝癌术后患者的总病情缓解率和无病生存期。

Application of oxaliplatin combined with xeloda for postoperatiive chemotherapy of hepatocellular carcinoma

Objective To investigate the effectiveness and safety of oxaliplatin combined with xeloda regimen as adjuvant chemotherapy for hepatocellular carcinoma.Methods From April 2006 to June 2008,forty-six patients with primary hepatocellular carcinoma received surgical resection and postoperative chemotherapy were analyzed retrospectively.Among them,27 patients who received oxaliplatin combined with xeloda regimen were grouped as treatment group（TG）.19 patients who were treated with the combination of 5-fu,Adriamycin and Mitomycin were grouped as control group（CG）.The effectiveness（CR、PR、SD、PD、ORR、OS and DFS） of the regimens according to RECIST criteria and WHO criteria for anticancer drugs toxicity were evaluated.Results Forty-six patients were successfully evaluated.In TG,ten patients were obtained complete remission（CR）,nine were got partial remission（PR）,three were got stable disease（SD） and five patients were got progression disease（PD）,and the side effect mainly was peripheric neurotoxicity but could be tolerant.While in control group,five patients were obtained complete remission（CR）,two patients were got PR,four patients were got SD and eight were got PD,and the side effects mainly were different degree bone marrow depression and digestive tract toxic reaction which could be relieved after symptomatic treatment.No significant differences were found in CR,PR,SD and PD（P0.05）.But significant differences were found in overall response rate（ORR）（P=0.0355）and disease-free survival（DFS）（P=0.0004）between the two groups.Conclusion Oxaliplatin combinated with xeloda regimen might be an effective choice in adjuvant chemotherapy for HCC.The regimen might further improve the overall response rate（ORR）and disease-free survival（DFS） of postoperaive patients with hepatocellular carcinoma.