摘要
目的探讨多西他赛碘油混悬剂经导管肝动脉化疗栓塞(TACE)治疗原发性肝癌的临床应用,探索更有效的TACE治疗用药,为临床治疗肝癌提供一定指导.方法随机收集2012年10月至2014年10月符合原发性肝癌诊断标准患者52例,随机分为A、B 2组,其中男32例,女20例,A组(多西他赛碘油混悬剂及吉西他滨)和B组(表柔比星碘油混悬剂及吉西他滨),观察2组患者近期疗效、肝功能情况、生活质量、KPS评分、AFP变化、累计生存期等变化.52例原发性肝癌患者中,性别、年龄、HBSAg(+)及Child-Pugh评分等方面差异无统计学意义(P>0.05),提示入组患者一般情况基本均衡.结果 A组中疾病控制率7例(21.8%),B组中疾病控制率4例(20.0%),2组差异无统计学意义(P>0.05);A组中肿瘤客观有效率27例(84.3%),B组中肿瘤客观有效率16例(80.0%),2组差异无统计学意义(P>0.05).在PR、SD、PD方面A、B 2组差异均没有统计学意义(P>0.05).2组患者术后血清AFP较术前明显降低,差异有统计学意义(P<0.05);术后两组患者血清AFP较术前AFP差值差异有统计学意义(P<0.05).A组患者平均生存期14.4个月,中位生存期13.7个月.B组患者平均生存期为12.1个月,中位生存期9.7个月,A、B 2组患者6和24个月生存率差异没有统计学意义(P>0.05).但在12个月和18个月A、B 2组差异有统计学意义(P<0.05),A组术后肝功能较B组术后肝功能有所改善,差异有统计学意义(P<0.05).在生存质量(KPS)方面,AB 2组治疗后3个月内KPS评分逐渐增高,3个月以后开始降低.A组治疗后1个月、6个月、12个月KPS评分高于B组,差异有统计学意义(P<0.05).结论 2组介入治疗方案对原发性肝癌均有一定效果,但多西他赛联合碘油TACE治疗原发性肝癌,在提高病人生活质量,延长患者生存时间,减少肝功能损害、抑制肿瘤细胞等方面较B组有优势,值得临床推广应用.
Objective The study was aimed to explore the clinical application of iodine oil-docetaxel-suspension in transcatheter arterial chemoembolization（TACE） for primary hepatic carcinoma and find out more effective treatment of TACE to provide a guidance for clinical treatment. Methods 52 patients who were diagnosed with primary hepatic carcinoma during October 2012 to August 2014 were randomly divided into groups A and B,including 32 male and 20 female cases. Group A was given iodine oil-docetaxel-suspension and gemcitabine treatment and group B received iodine oil-epirubicin-suspension and gemcitabine treatment. A comparison was conducted in the curative effect, liver function, quality of life, KPS score, AFP changes, the cumulative survival and other changes of patients between the two groups. Results There were no significant differences in gender, age, HBs Ag（＋） and the Child-Pugh score of 52 cases（P〈0.05）. The disease control rate in groups A and B was 21.8%（7 cases） and 20%（4 cases）, and there was no significant difference between the two groups（P〉0.05）. The tumor response rate in groups A and B was 84.3%（27 cases） and 80%（16 cases）,with no significant difference（P〉0.05）. There were no significant differences in PR,SD and PD between the two groups（P〈0.05）. Postoperative serum AFP of patients in the two groups was significantly decreased compared with preoperative（P〈0.05）. The mean survival time and median survival period of group A were 14.4 and 13.7months, while those of group B were 12.1 and 9.7 months,respectively. There were no significant differences in 6and 24 months survival rates between the two groups（P〉0.05）, but there were significant differences in 12 and18 months（P〈0.05）. Compared with group B,liver function was improved in group A after TACE, with a significant difference（P〈0.05）. In the quality of life, KPS scores of two groups increased gradually within 3months after TACE,but reduced after 3 months. The KPS scores of group A were higher than those of group B on1, 6 and 12 months after TACE（P〈0.05）. Conclusion The interventional therapy of two groups are both effective in treating primary hepatic carcinoma. But iodine oil-docetaxel-suspension TACE for primary hepatic carcinoma has advantages in improving the quality of life, prolonging the survival time,reducing the damage of liver function,and inhibiting tumor cell growth,whicht is worthy of clinical promotion.
出处
《昆明医科大学学报》
CAS
2016年第3期60-66,共7页
Journal of Kunming Medical University
基金
云南省教育厅科学研究基金资助项目(2012Y033)
关键词
原发性肝癌
多西他赛
TACE
Pimary hepatic carcinoma
Docetaxel
Transcatheter arterial chemoembolization
