TACE术中应用吉西他滨对原发性肝癌疗效及血清甲胎蛋白的影响
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摘要
目的分析肝动脉化疗栓塞术(TACE)中应用吉西他滨治疗原发性肝癌(PHC)的疗效及安全性。方法回顾性分析2015年3月—2016年3月80例PHC患者的临床资料,按照TACE使用药物的不同分为研究组和对照组,每组40例。研究组给予吉西他滨为主的TACE方案,对照组给予洛铂为主的TACE方案。分别比较2组的临床疗效、血清甲胎蛋白(AFP)、毒副反应及预后情况。结果 2组的客观有效率、1年生存率和毒副反应发生情况比较差异无统计学意义(P>0.05)。研究组的疾病控制率和2年生存率明显高于对照组(P<0.05)。治疗后,2组血清AFP水平明显低于治疗前,且研究组明显低于对照组(P<0.05)。结论 TACE中应用吉西他滨对PHC的临床疗效肯定,可有效降低患者血清AFP水平,提高生存率,且不增加治疗后的毒副反应。
Objective To analyze efficacy and safety of Gemcitabine application during transcatheter arterial chemoembolization(TACE) in treatment of patients with primary hepatocellular carcinoma(PHC). Methods Clinical data of 80 patients with PHC during March 2015 and March 2016 was retrospectively analyzed, and the patients were divided into study group and control group(n=40 for each group) according to different drug uses for TACE. Study group was given Gemcitabine-based TACE, while control group was given Lobaplatin-based TACE. Clinical efficacy, serum alpha-fetoprotein(AFP) level, toxicity and side reactions and prognosis were compared in two groups. Results There were no significant differences in objective effective rate, 1-year survival rate and incidence rate of toxic and side reactions between two groups(P>0.05). Disease control rate and 2-year survival rate in study group were significantly higher than those in control group(P<0.05). After treatment, levels of serum AFP were significantly lower than those before treatment in two groups, and the level in study group was significantly lower than that in control group(P<0.05). Conclusion Gemcitabine application during TACE for patients with PHC may achieve definedly clinical efficacy, and it may effectively reduce level of serum AFP and improve survival rate without increasing toxicity and side reactions after treatment.
Objective To analyze efficacy and safety of Gemcitabine application during transcatheter arterial chemoembolization(TACE) in treatment of patients with primary hepatocellular carcinoma(PHC). Methods Clinical data of 80 patients with PHC during March 2015 and March 2016 was retrospectively analyzed, and the patients were divided into study group and control group(n=40 for each group) according to different drug uses for TACE. Study group was given Gemcitabine-based TACE, while control group was given Lobaplatin-based TACE. Clinical efficacy, serum alpha-fetoprotein(AFP) level, toxicity and side reactions and prognosis were compared in two groups. Results There were no significant differences in objective effective rate, 1-year survival rate and incidence rate of toxic and side reactions between two groups(P>0.05). Disease control rate and 2-year survival rate in study group were significantly higher than those in control group(P<0.05). After treatment, levels of serum AFP were significantly lower than those before treatment in two groups, and the level in study group was significantly lower than that in control group(P<0.05). Conclusion Gemcitabine application during TACE for patients with PHC may achieve definedly clinical efficacy, and it may effectively reduce level of serum AFP and improve survival rate without increasing toxicity and side reactions after treatment.
引文
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[12] 杜波,张鹏.NK细胞治疗对原发性肝癌患者免疫功能及肝功能的影响[J].临床误诊误治,2017,30(7):88-90.
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[17] 周蔼斌,周俊平,芦东徽,等.经导管肝动脉化疗栓塞术联合三维适形放疗治疗巨大原发性肝癌疗效分析[J].实用肝脏病杂志,2017,20(2):195-198.
[18] 肖朝辉,王兆海,余灵祥,等.肝动脉化疗栓塞序贯射频消融治疗肝脏多发肿瘤的临床效果[J].中国医药,2018,13(8):1180-1184.
[19] 崔贤杰,范春花,汤小玉.雷替曲塞在TACE治疗中晚期原发性肝癌中疗效观察[J].现代仪器与医疗,2016,22(1):113-114,117.
[20] 陈旭姣,丁长伟,畅智慧,等.原发性肝癌患者肝动脉化疗栓塞术治疗前、后血浆D-二聚体变化的临床意义[J].介入放射学杂志,2017,26(12):1128-1132.
[21] 钱多,徐旭娟,李智,等.原发性肝癌患者肝动脉化疗栓塞术后自我管理效能干预的效果观察[J].护理学报,2016,23(22):44-49.
[22] 王肖辉,于杰,梁萍,等.甲胎蛋白预测肝癌微波消融疗效的价值[J].中华消化外科杂志,2012,11(2):159-162.
[23] 苏江,王科.甲胎蛋白与原发性肝癌临床病理因素及预后的相关性研究[J].中国综合临床,2012,28(10):1101-1103.
[24] 赵勇,魏国,胡礼冲,等.肝动脉化疗栓塞术对原发性肝癌合并HIV/AIDS患者T淋巴细胞亚群的影响[J].成都医学院学报,2017,12(6):727-731,735.
[2] 周萍,侯文强,吕元军,等.肝脏CT灌注成像对肝动脉栓塞化疗联合中药治疗原发性肝癌的临床疗效评价[J].解放军医药杂志,2016,28(6S):52-54.
[3] 王一焯,苟庆,许荣德,等.肝动脉化疗栓塞与单纯栓塞治疗原发性肝癌近期疗效的回顾性比较[J].临床放射学杂志,2018,37(5):855-859.
[4] 童玉云,张磊,王家平,等.多西他赛联合碘化油TACE治疗原发性肝癌的应用[J].昆明医科大学学报,2016,37(3):60-66.
[5] 侯计平,韩恩崑,杜庆云.雷替曲塞联合吉西他滨治疗原发性肝癌的临床研究[J].现代药物与临床,2017,32(2):263-266.
[6] 贺爱军,任羽,姬乐,等.肝动脉化疗栓塞术(TACE)对原发性肝癌患者的肝功能影响及相关因素分析[J].中国实验诊断学,2016,20(9):1507-1509.
[7] Aliberti C, Carandina R, Sarti D, et al. Hepatic arterial infusion of polyethylene glycol drug-eluting beads for primary and metastatic liver cancer therapy[J].Anticancer Res, 2016,36(7):3515-3521.
[8] 赵永昌,陈士新,刘亚民,等.经肝动脉介入化疗栓塞治疗对原发性肝癌患者免疫功能的影响[J].实用癌症杂志,2017,32(8):1273-1275.
[9] 陈秋英,马荣芬,时秀菊,等.肝动脉化疗栓塞术对原发性肝癌患者血清甲胎蛋白异质体和肝功能的影响[J].河北医药,2017,39(13):1948-1951.
[10] 武中林,吴勇超,杨超,等.原发性肝癌经导管肝动脉化疗栓塞术后应用不同保肝方案的效果比较研究[J].中国全科医学,2017,20(23):2862-2867,2874.
[11] 王斐斐,柳仲秋,贺启华,等.84例原发性肝癌患者肝动脉化疗栓塞术后预后的影响因素分析[J].癌症进展,2017,15(1):85-87,93.
[12] 杜波,张鹏.NK细胞治疗对原发性肝癌患者免疫功能及肝功能的影响[J].临床误诊误治,2017,30(7):88-90.
[13] 高靖琰,陈富坤,鄢佳文,等.肝动脉化疗栓塞联合调强放疗治疗原发性肝癌的临床疗效[J].昆明医科大学学报,2017,38(1):95-98.
[14] Hatooka M, Kawaoka T, Aikata H, et al. Comparison of outcome of hepatic arterial infusion chemotherapy and sorafenib in patients with hepatocellular carcinoma refractory to transcatheter arterial chemoembolization[J].Anticancer Res, 2016,36(7):3523-3529.
[15] 李伟男,杨刚,李敬东,等.术前经肝动脉化疗栓塞联合肝切除治疗原发性肝癌疗效的Meta分析[J].中华普通外科杂志,2017,32(1):61-66.
[16] 刘天保,刘占河,吴玉叶.经导管肝动脉化疗栓塞术治疗中晚期原发性肝癌患者的疗效与安全性再认识[J].实用肝脏病杂志,2017,20(4):507-508.
[17] 周蔼斌,周俊平,芦东徽,等.经导管肝动脉化疗栓塞术联合三维适形放疗治疗巨大原发性肝癌疗效分析[J].实用肝脏病杂志,2017,20(2):195-198.
[18] 肖朝辉,王兆海,余灵祥,等.肝动脉化疗栓塞序贯射频消融治疗肝脏多发肿瘤的临床效果[J].中国医药,2018,13(8):1180-1184.
[19] 崔贤杰,范春花,汤小玉.雷替曲塞在TACE治疗中晚期原发性肝癌中疗效观察[J].现代仪器与医疗,2016,22(1):113-114,117.
[20] 陈旭姣,丁长伟,畅智慧,等.原发性肝癌患者肝动脉化疗栓塞术治疗前、后血浆D-二聚体变化的临床意义[J].介入放射学杂志,2017,26(12):1128-1132.
[21] 钱多,徐旭娟,李智,等.原发性肝癌患者肝动脉化疗栓塞术后自我管理效能干预的效果观察[J].护理学报,2016,23(22):44-49.
[22] 王肖辉,于杰,梁萍,等.甲胎蛋白预测肝癌微波消融疗效的价值[J].中华消化外科杂志,2012,11(2):159-162.
[23] 苏江,王科.甲胎蛋白与原发性肝癌临床病理因素及预后的相关性研究[J].中国综合临床,2012,28(10):1101-1103.
[24] 赵勇,魏国,胡礼冲,等.肝动脉化疗栓塞术对原发性肝癌合并HIV/AIDS患者T淋巴细胞亚群的影响[J].成都医学院学报,2017,12(6):727-731,735.