摘要
目的探讨口服替吉奥联合肝动脉化疗栓塞术（TACE）序贯肝动脉灌注奥沙利铂治疗转移性肝癌的临床疗效。方法 2008年3月至2011年3月56例胃癌远端根治术后肝转移患者,按照治疗方法分为实验组（26例肝转移癌78个）及对照组（30例肝转移癌90个）。实验组予TACE序贯肝动脉灌注奥沙利铂联合口服替吉奥治疗;对照组进行TACE序贯肝动脉灌注奥沙利铂治疗。肿瘤总数168个,肿瘤平均最大直径（2.9±1.3）cm,治疗后定期进行影像学和肿瘤标志物检查。结果 56例患者共接受了144例次的TACE治疗。治疗1个月后行增强CT检查,实验组26例78个肿瘤中70个完全消融,完全消融率为89.74%（70/78）;对照组30例90个肿瘤中61个完全消融,完全消融率为67.78%（61/90）,实验组肿瘤完全消融率明显高于对照组（P〈0.01）。随访3~24个月,实验组肿瘤局部复发率[11.54%（9/78）]明显低于对照组[24.44%（22/90）,P〈0.05]。1、2年生存率实验组分别为76.92%、57.69%,对照组分别为40.00%、20.00%;实验组1、2年生存率明显高于对照组（P均〈0.01）。两组患者治疗后均未出现严重并发症。结论胃癌术后TACE序贯肝动脉灌注奥沙利铂联合口服替吉奥治疗转移性肝癌较单纯TACE序贯肝动脉灌注奥沙利铂具有较高的肿瘤消融率、较低的肿瘤局部复发率及较高的生存率。
Objective To explore the clinical effect of S-1 （tegafur/gimeraciL/oteracil potassium）capsules combined with transcatheter arterial chemoembolization （TACE） sequential hepatic artery infusion with oxaliplatin for the treatment of me- tastatic liver cancer （MLC）. Methods Fifty-six patients with MLC after distal gastric cancer radical operation between March 2008 and March 2011 were divided into two groups according to treatment method：experiment group （26 cases ,78 tumors） and control group （30 cases,90 tumors）. The therapy of S-1 combined with TACE sequential hepatic artery infu- sion with oxaliplatin were given in experiment group, TACE sequential hepatic artery infusion with oxaliplatin only was given in control group. The total number of tumors was 168, and the largest tumor diameter was （2. 9 ＋ 1.3 ）cm. The examinations of imaging and tumor markers were regularly performed after treatment. Results Fifty-six patients received 144 case-times TACE therapies. Enhanced CT at one month after treatment showed that in experiment group, out of 78 tumors, 70 were complete ablation,namely the complete ablation rate was 89.74% （70/78） ;in control group, out of 90 tumors,61 were complete ablation, namely the complete ablation rate was 67. 78 % （61/90）. The complete ablation rate in experiment group was significantly higher than that in control group （P 〈 0. 01 ）. The results followed-up for 3 to 24 months revealed that the tumor local recurrence rate in experiment group was significantly lower than that in control group [ 11.54% （ 9/78 ） vs 24. 44% （22/90）, P 〈 0. 05 ]. The 1- and 2-year survival rates were 76.92% and 57.69% in experiment group, and 40. 00% and 20. 00% in control group; the 1- and 2-year survival rates in experiment group significantly increased com- pared with control group （all P 〈 0. 01 ）. After treatment, severe complications were not found in two groups. Conclusions Compared with TACE sequential hepatic artery infusion with oxaliplatin only, TACE sequential hepatic artery infnsion with oxaliplatin combined with oral S-1 has the advantages of higher tumor ablation rate,lower tumor local recurrence rate and higher survival rate for the treatment of liver metastasis after gastric cancer resection.
出处
《中国临床研究》
CAS
2015年第5期559-562,共4页
Chinese Journal of Clinical Research
基金
国家高技术研究发展计划(863计划)子课题(2014AA022304)
关键词
胃癌
肝癌
转移性
替吉奥
奥沙利铂
肝动脉化疗栓塞术
肝动脉灌注
Gastric cancer
Liver cancer, metastatic
S-1 （tesafur/gimeracil/oteracil potassium） capsules
Oxaliplatin
Transcatheter hepatic artery chemoembolization
Hepatic artery infusion
