原发性肝癌术后FOLFOX4方案辅助化疗的临床分析

目的：评价原发性肝癌（HCC）根治性切除术后应用辅助化疗的临床疗效。方法：将89例原发性HCC根治术后患者应用随机数字表法随机分为治疗组和对照组。治疗组45例，给予FOLFOX4（奥沙利铂＋CF＋5-FU）方案辅助化疗。对照组44例，术后给予营养支持及对症治疗。结果：治疗组AFP≥400μg／L的患者中有82．1％降至400μg／L，明显高于对照组的55．6％（P=0．01），治疗组1、2和3年生存率分别为77．8％、64．4％和33．3％，明显高于对照组的54．5％、40．9％和17．5％（P=0．02）。治疗组的1、2和3年复发率低于对照组，但两组差异无统计学意义。辅助化疗的毒副作用主要为胃肠道副反应、骨髓抑制和神经毒性，经对症治疗均可好转。结论：原发性HCC根治术后行FOLF0x4方案辅助化疗能降低复发率，延长生存时间。

Clinical analysis on FOLFOX4 as adjuvant chemotherapy after resection for primary hepatocellular carcinoma

OBJECTIVE： To evaluate clinical efficacy of adjuvant chemotherapy on primary hepatocellular carcinoma after the resection. METHODS： A total o{ 46 patients with curative resection were randomly divided into treatment group and control group. In treatment group 45 patients received FOLFOX4 （Oxaliplatin q- CF ＋5- FU） as adjuvant chemo- therapy and in the control group 44 patients received symptomatic postoperative nutritional support and treatment. RE- SULTS： The AFP level in 82.1% of the patients in the treatment group decreased to 400 ~g/L from more than 400 t~g/L. The decreased ratio was higher than that in the control group （P：0.01）. 1,2,3-year survival rates were 77.8%, 64.4% and 33.3%, which was significantly higher than 54.5%, 40.9% and 17.5% in control group （P=0.02）. The 1,2,3-year recurrence rates of treatment group were lower than that in the control group but there were no statistic difference in the two groups. Toxicity of adjuvant chemotherapy mainly were gastrointestinal side effects, bone marrow suppression and neurotoxicity, which may be improved by symptomatic treatment. CONCLUSION： FOLFOX4 as adjuvant chemotherapy can reduce the recurrence rate and prolong survival time.