吉西他滨热化疗灌注联合TACE对肝癌患者疗效及肿瘤细胞因子水平的影响  

Effects of Gemcitabine Heat-perfusion Chemotherapy Combined with TACE on Treatment of Hepatocellular Carcinoma and Levels of Tumor Cytokines

作　　者：喻雄杰[1] 李艳丽[1] 雷金华[1] 俞远东[1] 狄全书[1] 曹凤军[1] 

机构地区：[1]湖北医药学院附属人民医院肿瘤科,湖北十堰442000

出　　处：《医学综述》2016年第20期4107-4110,共4页Medical Recapitulate

摘　　要：目的 探讨吉西他滨热化疗灌注联合经导管动脉化疗栓塞术（TACE）治疗肝癌的疗效及其对血管内皮生长因子（VEGF）、可溶性白细胞介素2受体（sIL-2R）、缺氧诱导因子2α（HIF-2α）水平的影响。方法 选取2012年1月至2013年1月湖北医药学院附属人民医院肿瘤科收治的84例中晚期肝癌患者为研究对象,采用随机数字表法将患者分为联合治疗组和热灌注化疗组,各42例。热灌注化疗组给予吉西他滨热化疗灌注治疗,联合治疗组在此基础上联合TACE治疗,两组患者均完成8个周期的治疗。比较分析两组患者的近期疗效、不良反应、远期生存率以及治疗前后两组患者血清VEGF、sIL-2R、HIF-2α水平。结果 联合治疗组近期的总有效率[85.7%（36/42）]及疗效均高于热灌注化疗组[52.4%（22/42）],差异均有统计学意义（χ^2=10.918,P〈0.05;Z=5.092,P〈0.05）;联合治疗组无进展生存期为（18.9±3.8）个月,热灌注化疗组为（12.8±3.1）个月,比较差异有统计学意义（t=8.118,P=0.000）;联合治疗组总生存率、无瘤生存率高于热灌注化疗组（76.2%比35.7%、52.4%比19.0%）,而复发率低于热灌注化疗组（11.9%比33.3%）,差异有统计学意义（P〈0.05）;两组患者化疗不良反应发生情况比较,差异无统计学意义（P〉0.05）;治疗后,两组患者血清VEGF、sIL-2R、HIF-2α水平较治疗前降低,且联合治疗组血清VEGF、sIL-2R、HIF-2α水平较热灌注化疗组更低,差异均有统计学意义（P〈0.01）。结论 吉西他滨热化疗灌注联合TACE能有效提高肝癌的治疗效果,延缓病情进展,提高患者远期生存率,且不增加不良反应,其作用机制可能与其抑制VEGF、sIL-2R、HIF-2α的表达有关。Objective To investigate the effects of gemcitabine heat-perfusian chemotherapy combined with transcatheter arterial chemoembolization（ TACE ） on treatment of hepatocellular carcinoma cancer and the influence on levels of vascular endothelial growth factor （VEGF）, soluble interleukin-2 receptor （sIL-2R） ,hypexia inducible factor 2α（HIF-2α）. Methods Total of 84 cases of hepatocellular carcinoma in Renmin Hospital Affiliated to Hubei University of Medicine from Jan. 2012 to Jan. 2013 were divided into a therapeutic alliance group and a heat-perfusiou group according to the random number table method, 42 cases in each group. The heat-perfusion group received gemeitabine heat perfusion chemotherapy, and the therapeutic alliance group received TACE on the basis of heat-perfusion group. Both groups received eight cycles of therapy. The short-term efficacy,side effect,long-term survival and the levels of VEGF,sIL-2R, HIF-2α of the two groups were compared. Results The total efficacy（85.7% ,36/42） and curative effect of the therapeutic alliance group were higher than the heat-perfusiou group （52. 4%,22/42 ） （ x^2 = 10. 918,P 〈 0. 05;Z = 5.092, P 〈 0. 05 ）. Progression-free survival of the therapeutic alliance group were （18.9 ± 3.8） months, of the heat-perfusion group were （ 12. 8 ±3. 1 ） months, the difference was statistically significant （ t = 8. 118, P =0. 000 ）. The overall survival rate, disease-free survival and the recurrence rate of the therapeutic alliance group were 76.2%,52.4%, 11.9%, and the heat-peffusion group were 35.7%, 19. 0%, 33.3% respectively, the difference was statistically significant （P 〈 0. 05 ）. There was no significant difference between the two groups on side effect （ P 〉 0. 05 ）. The levels of VEGF, sIL-2R and HIF-2α in both groups were decreased after treatment（ P 〈 0. 05 ）, while the therapeutic alliance group was significantly lower than the heat-perfusion group （ P 〈 0. 01 ）. Conclusion Gemcitabine heat perfusian c

关 键 词：肝癌 吉西他滨热化疗灌注 经导管动脉化疗栓塞术 血管内皮生长因子 白细胞介素2受体 缺氧诱导因子2α 

分 类 号：R735.7[医药卫生—肿瘤]