雷替曲塞联合奥沙利铂经导管动脉化疗栓塞治疗原发性肝癌的疗效研究

目的 探讨雷替曲塞联合奥沙利铂经导管动脉化疗栓塞(TACE)治疗原发性肝癌的短期疗效及安全性.方法 收集75例原发性肝癌患者的临床资料,根据治疗方法的不同将患者分为研究组(n=39)和对照组(n=36),研究组患者接受雷替曲塞联合奥沙利铂栓塞化疗,对照组患者接受吡柔比星联合奥沙利铂栓塞化疗.比较两组患者的近期疗效、生存情况、甲胎蛋白(AFP)改变情况、不良反应发生率及血常规和肝肾功能指标.结果 两组患者的疾病控制率、生存情况和AFP下降率比较,差异均无统计学意义(P﹥0.05).术后3天研究组患者发热、肝区疼痛及恶心呕吐的发生率均明显低于对照组,差异均有统计学意义(P﹤0.01).治疗后研究组患者的总胆红素(TB)、直接胆红素(DB)、谷丙转氨酶(ALT)、谷草转氨酶(AST)水平均明显高于治疗前(P﹤0.01),血浆白蛋白水平低于治疗前(P﹤0.05);治疗后对照组患者的TB、DB、ALT、AST、白细胞计数(WBC)水平均高于治疗前(P﹤0.05),血浆白蛋白水平明显低于治疗前(P﹤0.01).治疗后研究组患者的血浆白蛋白水平高于对照组,差异有统计学意义(P﹤0.05);ALT、AST、γ-谷氨酰转移酶(γ-GT)、WBC水平均明显低于对照组,差异均有统计学意义(P﹤0.01).结论 雷替曲塞联合奥沙利铂TACE治疗原发性肝癌的不良反应较少,其近期疗效与吡柔比星联合奥沙利铂栓塞效果相当,远期疗效有待临床进一步研究.

Efficacy of transcatheter arterial chemoembolization of raltitrexed combined with oxaliplatin for primary liver cancer

Objective To analyze the short-term efficacy and safety of transcatheter arterial chemoembolizaton (TACE) of raltitrexed combined with oxaliplatin on primary liver cancer.Method 75 primary liver cancer patients were collected for their clinical profiles,and were divided as study group (n=39) or control group (n=36) by respective treat-ment administered,patients in study group were given TACE of raltitrexed plus oxaliplatin,and those in control group were treated with TACE of pirarubicin and oxaliplatin.The short-term efficacy,survival,change of AFP,incidence of ad-verse reactions,hematology and liver and renal functions were compared between the two groups.Result The disease control rate (DCR),survival and decrease of AFP were of no statistical significance in two groups (P>0.05).In 3 days af-ter surgery,the incidence of fever,liver pain,nausea and vomiting were lower in study group compared to control group,showing statistically significant difference (P<0.01).After treatment,the total bilirubin (TB),direct bilirubin (DB),ala-nine aminotransferase (ALT),aspartate aminotransferase (AST) were increased (P<0.01),while ALB was decreased (P>0.05);after treatment,the TB,DB,ALT,AST,WBC levels were increased as compared with before treatment (P<0.05),but ALB was declined significantly (P<0.01).The ALB was higher in study group than in control group after treatment,demonstrating significant difference (P<0.05),while ALT,AST,γ-GT,and WBC were lower than those in control group,indicating statistically significant differences (P<0.01).Conclusion TACE of raltitrexed combined with oxaliplatin in-duced less adverse reactions when used in treating primary liver cancer,with similar short-term efficacy with pirarubicin plus oxaliplatin,while more studies are warranted for the long-term curative effect.