摘要
目的评价雷替曲塞联合经肝动脉化疗栓塞术在治疗晚期大肠癌肝转移中的疗效。方法选取中国石油天然气集团公司中心医院2012年1月^(-2)015年6月收治的大肠癌术后晚期肝转移的患者80例,将其随机分为研究组和对照组,每组40例。研究组给予雷替曲塞介入下肝动脉灌注化疗联合栓塞治疗,对照组给予静脉输注雷替曲塞单药治疗。以上治疗每4周1次,共进行3~6个周期。观察2组的治疗有效率(RR)、疾病控制率(DCR)、中位疾病进展时间、生存率以及癌胚抗原(CEA)、糖链抗原(CA)19-9、转氨酶、胆红素的下降情况。计数资料组间比较采用χ~2检验,生存分析采用Kaplom-Meier法。结果研究组的RR与对照组(45.0%vs 22.5%)比较,差异有统计学意义(χ~2=4.528,P=0.033);研究组的DCR与对照组(70.0%vs 47.5%)比较,差异有统计学意义(χ~2=4.178,P=0.041)。研究组的中位疾病进展时间与对照组(17.9个月vs 10.5个月)比较,差异有统计学意义(χ~2=24.08,P<0.001)。研究组的1、2年生存率分别为80.0%、55.0%,对照组的分别为57.5%、32.5%,2组比较,差异均有统计学意义(χ~2值分别为4.713、4.114,P值分别为0.030、0.043)。研究组化疗栓塞术后2个月的CA19-9、CEA、转氨酶、胆红素水平下降超过50%的病例数均较对照组多,差异均有统计学意义(χ~2值分别为5.333、4.528、5.051、5.013,P值分别为0.021、0.033、0.025、0.025)。结论雷替曲塞联合经肝动脉化疗栓塞术在治疗晚期大肠癌肝转移中有一定的价值,值得临床推广。
Objective To investigate the efficacy of raltitrexed combined with transcatheter arterial chemoembolization（ TACE） in the treatment of advanced colorectal cancer with liver metastasis. Methods A total of 80 patients with liver metastasis of advanced colorectal cancer who were admitted to Central Hospital of China National Petroleum Corporation and underwent surgery from January 2012 to June 2015 were enrolled and randomly divided into study group and control group,with 40 patients in each group. The patients in the study group underwent hepatic arterial infusion chemotherapy with raltitrexed combined with TACE,and those in the control group were treated with intravenous infusion of raltitrexed alone. The above treatment was performed once every 4 weeks for 3- 6 cycles. The response rate（ RR）,disease control rate（ DCR）,median time to disease progression,survival rate,and reductions in carcinoembryonic antigen（ CEA）,CA19- 9,aminotransferases,and bilirubin were observed in the two groups. The chi- square test was used for comparison of categorical data between groups.Results RR,DCR,and the median time to disease progression showed significant differences between the study group and the control group（ 45. 0% vs 22. 5%,χ-2= 4. 528,P = 0. 033; 70. 0% vs 47. 5%,χ-2= 4. 178,P = 0. 041; 17. 9 months vs 10. 5 months,χ-2=24. 08,P〈0. 001）. The study group had significantly higher 1- and 2- year survival rates than the control group（ 80. 0% vs 57. 5%,χ-2= 4. 713,P = 0. 030; 55. 0% vs 32. 5%,χ-2= 4. 114,P = 0. 043）. The study group had a significantly higher number of patients with more than 50% reductions in CA19- 9,CEA,aminotransferases,and bilirubin at 2 months after TACE than the control group（ χ-2= 5. 333,4. 528,5. 051,and 5. 013,P = 0. 021,0. 033,0. 025,and 0. 025）. Conclusion Raltitrexed combined with TACE is of good value in the treatment of advanced colorectal cancer with liver metastasis and holds promise for clinical application.
出处
《临床肝胆病杂志》
CAS
2016年第4期742-745,共4页
Journal of Clinical Hepatology
基金
廊坊市科学技术研究与发展计划项目(2014013021)
关键词
肠肿瘤
肝肿瘤
化学栓塞
治疗性
intestinal neoplasms
liver neoplasms
chemoembolization
therapeutic
