重组人血管内皮抑素治疗老年性肝癌腹腔积液患者的近远期生存质量评估  

Rh-endostatin combined with chemotherapy in management of malignant pleural effusion in elderly patients with liver cancer:clinical efficacy and quality of life

作　　者：刘兴强[1] 王霞[2] 刘超[3] Xing-qiang Liu Xia Wang Chao Liu(Department of Surgery Emergency Department, Tianjin People ＂s Hospital, Tianjin 300121, China Department of Cardiology, Tianjin Thoracic Hospital, Tianjin 300222, China)

机构地区：[1]天津市人民医院普外科,天津300121 [2]天津市人民医院急诊科,天津300121 [3]天津市胸科医院心内科,天津300222

出　　处：《中国现代医学杂志》2017年第2期71-75,共5页China Journal of Modern Medicine

基　　金：2013年中国博士后科学基金(No:2013M530880);2013年中国博士后科学基金(No:2015M581308)

摘　　要：目的探讨重组人血管内皮抑素治疗老年性肝癌腹腔积液患者的近远期生存质量。方法选取2013年1月-2015年12月肝癌伴腹腔积液患者125例。其中男性85例,女性40例,中位年龄71岁,均为Ⅲ、Ⅳ期肝癌。依据随机原则并结合患者选择意愿将患者分为两组:单纯顺铂组(对照组)60例,重组人血管内皮抑素+顺铂组(观察组)65例。对患者的疗效、生存质量进行随访。结果观察组在应用重组人血管内皮抑素治疗后,完全缓解16例(24.6%)、部分缓解34例(52.3%)、病情稳定11例(16.9%)、病情进展4例(6.2%),治疗有效率达76.9%,控制率为93.8%。两组总体疗效比较,观察组优于对照组,差异有统计学意义(χ2=18.402,P=0.000);两组治疗有效率比较,观察组优于对照组,差异有统计学意义(χ2=16.159,P=0.000);Kaplan-Meier生存分析发现,观察组1、3和5年总生存率分别为86.2%、30.8%和18.5%,优于对照组(Log-Rank检验,χ2=3.859,P=0.049)。观察组的整体生活质量优于对照组(t=18.645,P=0.041);该研究中关于预后评估因素对比分析显示,重组人血管内皮抑素应用及KPS>80分对患者治疗后生存时间和生存率有明显影响。结论重组人血管内皮抑素对老年肝癌合并腹腔积液患者的肿瘤控制、生存率提高、近远期生存质量改善、减少毒性反应等方面有优良效果,成为该病一种有效而安全的治疗方法,值得临床推广。Objective To evaluate the efficacy and quality of life of Rh-endostatin combined with chemotherapy in the management of malignant pleural effusion in elderly patients with liver cancer： clinical efficacy and toxicity. Methods A total of 125 patients with stage Ⅱ and Ⅳ liver cancer were treated with Rh-endostatin combined with chemotherapy from January 2013 to December 2015 were selected. The patients were randomly divided into two groups. The observation group were treated with Rh-endostatin combined with chemotherapy, and the control group only with chemotherapy. Clinical efficacy and short-term and long-term quality of life were assessed. Results In the observation group, the application of Rh-endostatin resulted in complete response in 16 cases （24.6%）, partial response in 34 cases （52.3%）, stable disease in 11 cases （16.9%） and progressive disease in 4 cases （6.2%）. Within the study group, complete response rate （CR＋PR） was 76.9% and the control rate （CR＋PR＋SD） was 93.8%, which were higher than those of the control group （X^2 = 18.402, P = 0.000）. The effective rate of the observation group was significantly higher than that of the control group （X^2 = 16.159, P = 0.000）. The 1-year, 3-year and 5-year overall survival rates were 86.2 %, 30.8%, and 18.5% respectively by Kaplan-Meier method, which were significantly better than those of the control group （Log Rank test, X^2 = 3.859, P = 0.049）. Short and long-term quality of life in the observation group was better than that in the control group （t = 18.645, P = 0.041）. In this study, a comparative analysis of prognostic factors showed that Rh-endostatin and KPS score〉80 points significantly affected the survival time and survival rate of the patients after treatment. Conclusions The combination of Rh-endostatin and chemotherapy results in high local control of malignant pleural effusion, few complications and good survival quality in the elderly patients with liver cancer.

关 键 词：重组人血管内皮抑素 化疗 肝癌 控制率 生存时间 

分 类 号：R735.7[医药卫生—肿瘤]