中性粒细胞/淋巴细胞比值对晚期肝细胞癌FOLFOX肝动脉灌注化疗近期疗效的影响  

Effects of neutrophil to lymphocyte ratio on short-term efficacy of FOLFOX hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma

作　　者：吴林耿 陈猛 苟庆 麦启聪 周泽健 WU Lingeng;CHEN Meng;GOU Qing;MAI Qicong;ZHOU Zejian(Department of Interventional Therapy,Cancer Center,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences),Guangzhou 510080,China;Medical College of Shantou University,Shantou 515041,China)

机构地区：[1]广东省人民医院(广东省医学科学院)肿瘤中心介入治疗科,广东广州510080 [2]汕头大学医学院,广东汕头515041

出　　处：《中国医学物理学杂志》2021年第5期602-605,共4页Chinese Journal of Medical Physics

摘　　要：目的:探讨中性粒细胞/淋巴细胞比值(NLR)对晚期肝细胞癌(HCC)动脉灌注化疗近期疗效的影响。方法:回顾性收集分析2017年5月~2019年3月使用FOLFOX肝动脉灌注化疗的晚期HCC患者共92例。通过CT或MR比较患者每个治疗周期后肿瘤局部反应,通过相关检查结果及临床症状观察患者疗效及肝动脉灌注安全性等。结果:根据mRECIST标准对肝内病灶进行评价,NLR<4.0组患者的客观缓解率显著高于NLR≥4.0组患者(41.5%vs 17.9%,P=0.016)。NLR<4.0组患者的疾病控制率显著优于NLR≥4.0组(52.8%vs 28.2%;P=0.018)。对于肝内病灶,NLR<4.0组的中位PFS(月)较NLR≥4.0组更长(6.1 vs 4.1,P=0.013)。针对全身肿瘤病灶进行疗效评估,NLR<4.0组和NLR≥4.0组之间的中位PFS(月)也有显著差异(4.3 vs 3.1,P=0.022)。结论:使用FOLFOX肝动脉灌注治疗HCC安全性及有效性均较好,且NLR是预测HCC灌注化疗术后疗效的指标,术前高NLR的HCC患者治疗后PFS较短。Objective To investigate the effects of neutrophil to lymphocyte ratio(NLR)on the short-term therapeutic efficacy of FOLFOX hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma(HCC).Methods A total of 92 patients with advanced HCC treated by FOLFOX hepatic arterial infusion chemotherapy from May 2017 to March 2019 were enrolled in the study.CT or MR was used to compare the local tumor response after each treatment cycle,and the therapeutic efficacy and safety of hepatic arterial perfusion were evaluated by relevant examination results and clinical symptoms.Results The intrahepatic lesions were evaluated according to mRECIST criteria.The objective response rate of NLR<4.0 group was significantly higher than that of NLR≥4.0 group(41.5%vs 17.9%,P=0.016).The disease control rate of NLR<4.0 group was also superior to that of NLR≥4.0 group(52.8%vs 28.2%,P=0.018).For intrahepatic lesions,the median progression free survival(PFS)in NLR<4.0 group was longer than that in NLR≥4.0 group(6.1 months vs 4.1 months,P=0.013);and the evaluation of the therapeutic efficacy of systemic tumor lesions showed that the median PFS was also significantly different between NLR<4.0 group and NLR≥4.0 group(4.3 months vs 3.1 months,P=0.022).Conclusion FOLFOX hepatic arterial infusion is safe and effective in treating HCC,and NLR is an indicator to predict the therapeutic efficacy of HCC perfusion chemotherapy.Patients with high NLR before surgery have shorter PFS after treatment.

关 键 词：肝细胞癌 中性粒细胞 淋巴细胞 FOLFOX 经导管动脉灌注化疗 

分 类 号：R735.7[医药卫生—肿瘤]