联合应用雷替曲塞及表柔比星经肝动脉化疗栓塞术治疗中晚期原发性肝癌的临床观察  

Intervention of raltitrexed combined with epirubicin in hepatic arterial infusion and embolization in treatment of primary liver cancer

作　　者：王保信[1] 武振明[1] 张锐[1] 胡新华 邹庆华[1] 范宜锋[1] 邢宏建[1] 肖芳芳[1] 齐秀恒[1] 

机构地区：[1]中国石油天然气集团公司中心医院,河北廊坊065000 [2]显德旺矿职工医院,河北邢台054000

出　　处：《临床肝胆病杂志》2015年第5期725-728,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)

摘　　要：目的：评价雷替曲塞联合表柔比星介入肝动脉灌注化疗栓塞在治疗中晚期原发性肝癌中的疗效。方法选取中国石油天然气集团公司中心医院2011年1月－2013年5月收治的80例不适合手术治疗的中晚期原发性肝癌患者，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联合表柔比星介入下肝动脉灌注化疗栓塞治疗，对照组给予氟尿嘧啶（5－FU）联合表柔比星介入下肝动脉灌注化疗栓塞治疗。以上治疗每4周1次，共进行3～6周期。观察两组的治疗有效率（RR）、疾病控制率（DCR）、中位疾病进展时间、生存率以及甲胎蛋白（AFP）、癌胚抗原（CEA）、转氨酶、胆红素的下降情况。计数资料组间比较采用χ2检验，计量资料组间比较采用 t 检验。结果研究组的 RR 为52．5％，对照组为22．5％，差异均有统计学意义（χ2＝7．680，P ＝0．006）；研究组的 DCR 为87．5％，对照组为60．0％，差异有统计学意义（χ2＝7．813，P ＝0．005）；研究组的中位疾病进展时间为12．2个月，对照组为8．0个月，差异有统计学意义（t ＝5．118，P ＝0．00）；研究组的1、2年生存率分别为为85．0％、60．0％，对照组分别为65．0％、37．5％，差异均有统计学意义（χ2值分别为4．267、4．053，P 值分别为0．039、0．044）；研究组化疗栓塞术后1个月 AFP、转氨酶、胆红素水平下降超过50％的病例数均多于对照组，差异均具有统计学意义（χ2值分别为4．381、4．114、5．000，P 值分别为0．036、0．043、0．025）。结论雷替曲塞联合表柔比星介入肝动脉灌注化疗栓塞对治疗中晚期原发性肝癌有一定价值，值得在临床中推广。Objective To evaluate the therapeutic effect of intervention of raltitrexed combined with epirubicin in hepatic arterial infusion and embolization in the treatment of advanced primary liver cancer.Methods A total of 80 patients with advanced primary liver cancer who were admitted to the Central Hospital of China National Petroleum Corporation from January 2011 to May 2013 and not suitable for surgical treatment were selected and randomly divided into study group （n =40）and control group （n =40）.The study group was treated with inter-vention of raltitrexed combined with epirubicin in hepatic arterial infusion and embolization,while the control group was treated with inter-vention of fluorouracil （5 -FU）combined with epirubicin in hepatic arterial infusion and embolization.The treatment was given once every four weeks for a total of three to six circles.The response rate （RR）,disease control rate （DCR）,median time to progression,survival rate,and the decreases in alpha fetoprotein （AFP）,carcinoembryonic antigen （CEA）,transaminase,and bilirubin of the two groups were observed.Comparison of categorical data between the two groups was made by chi -square test,and comparison of continuous data was made by t test.Results The RRs of the study group and control group were 52.5% and 22.5%,respectively,and the difference was significant （χ2 =7.680,P =0.006）;the DCRs of the study group and control group were 87.5% and 60.0%,respectively,and the difference was significant （χ2 =7.813,P =0.005）;the median time to progression of the study group and control group was 12.2 and 8.0 months,re-spectively,and the difference was significant （t =5.118,P =0.00）;the 1 -and 2 -year survival rates of the study group were 85.0%and 60.0%,respectively,with the control group being 65.0% and 37.5%,and the difference was significant （χ2 =4.267,P =0.039;χ2=4.053,P =0.044）.One month after chemoembolization,the number of patients whose AFP,transaminase,and bilirubin levels de-creased more than 50% in t

关 键 词：肝肿瘤 化学栓塞 治疗性 雷替曲塞 表柔比星 

分 类 号：R735.7[医药卫生—肿瘤]