吴晓邡,孟秋丽,万绍贵
WU Xiao-fang,MENG Qiu-li,WAN Shao-gui

• 1:长沙金林骨科医院内科
• 2:巩义市人民医院肿瘤血液科
• 3:南昌大学药学院

摘要(Abstract)：

目的探讨替吉奥联合肝动脉灌注化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗中晚期肝细胞癌(hepatocellular carcinoma,HCC)的临床疗效及安全性。方法中晚期HCC患者47例随机分为观察组23例和对照组24例;观察组采用TACE+替吉奥口服治疗,对照组采用TACE治疗;观察2组治疗有效率、疾病控制率、生存率及不良反应发生情况。结果观察组治疗有效率(65.22%)、疾病控制率(86.96%)及12、24个月生存率(78.26%、34.78%)均高于对照组(33.33%、50.00%、50.00%、8.33%)(P<0.05);2组不良反应轻微,均未出现Ⅳ度毒性反应,观察组腹痛(69.6%)、恶心(65.2%)、呕吐(43.5%)、发热(73.9%)、血细胞下降(13.0%)、肝功能损伤(8.7%)及外周神经毒性反应(4.3%)发生率与对照组(70.8%、58.3%、41.7%、75.0%、12.5%、8.3%、4.2%)比较差异均无统计学意义(P>0.05)。结论替吉奥联合TACE治疗中晚期HCC疗效确切,安全。
Objective To explore the clinical effect and safety of oral tegefur gimeracil oteracil combined with transcatheter arterial chemoembolization(TACE)in the treatment of advanced hepatocellular carcinoma(HCC).Methods Forty-seven patients with advanced HCC were randomly divided into observation group(n=23)receiving TACE combined with oral administration of tegefur gimeracil oteracil and control group(n=24)receiving TACE alone.The effective rate,disease control rate,survival and adverse reactions were observed.Results The effective rate(65.22%),diseases control rate(86.96%)and 24-and 48-month survival rates(78.26%,34.78%)in observation group were significantly higher than those in control group(33.33%,50.00%,50.00%,8.33%)(P<0.05).The adverse reactions were mild in both two groups,with no degreeⅣ toxicity.There were no significant differences in the incidences of abdominal pain(69.6% vs 70.8%),nausea(65.2% vs 58.3%),vomiting(43.5% vs 41.7%),fever(73.9%vs 75.0%),beucopenia(13.0%vs 12.5%),liver function injury(8.7%vs 8.3%)and peripheral neurotoxicity(4.3% vs 4.2%)between observation group and control group(P>0.05).Conclusion For advanced HCC,oral administration of tegefur gimeracil oteracil combined with TACE is effective and safe.

关键词(KeyWords)： 中晚期肝细胞癌;替吉奥;肝动脉灌注化疗栓塞术
Advanced hepatocellular carcinoma;tegefur gimeracil oteracil;transcatheter arterial chemoembolization

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81201578)

作者(Author): 吴晓邡,孟秋丽,万绍贵
WU Xiao-fang,MENG Qiu-li,WAN Shao-gui

参考文献(References)：

• [1]高婷,李超,梁锌,等.中国癌症流行的国际比较[J].中国肿瘤,2016,25(6):409-414.
• [2]EISENHAUERA E A,THERASSEB P,BOGAERTSC J,et al.New response evaluation criteria in solid tumours:Revised RECIST Guideline(version 1.1)[J].Eur J Cancer,2009,45(2):228-247.
• [3]CAVALETTI G,FRIGENI B,LANZANI F,et al.Chemotherapy-induced peripheral neurotoxicity assessment:a critical revision of the currently available tools[J].Eur J Cancer,2010,46(3):479-494.
• [4]孙晓.肝动脉化疗栓塞与伽马刀序贯联合疗法在中晚期肝细胞癌治疗中的临床应用研究[J].临床医学,2014,34(4):35-36.
• [5]杨广宁,刘群轶,翟鹏涛.肝动脉灌注栓塞术治疗肝癌的临床分析[J].中国肿瘤临床与康复,2014,21(8):956-958.
• [6]WANG Y X,DE BAERE T,IDEE J M,et al.Transcatheter embolization therapy in liver cancer:an update of clinical evidences[J].Chin J Cancer Res,2015,27(2):96-121.
• [7]李金燕,白星,任欣乐,等.吉西他滨联合奥沙利铂经肝动脉栓塞化疗治疗中晚期肝癌的临床疗效[J].中华实用诊断与治疗杂志,2014,28(5):509-510.
• [8]李欣,郑传胜,冯敢生,等.化疗栓塞后VEGF的表达及其与微血管密度和细胞增殖关系的实验研究[J].临床放射学杂志,2004,23(2):162-165.
• [9]KASEB A O,HASSAN M M,LIN E,et al.V-CLIP:integrating plasma vascular endothelial growth factor into a new scoring system to stratify patients with advanced hepatocellular carcinoma for clinical trials[J].Cancer,2011,117(11):2478-2488.
• [10]SEKI A,HORI S.Transcatheter arterial chemoembolization with docetaxel-loaded microspheres controls heavily pretreated unresectable liver metastases from colorectal cancer:a case study[J].Int J Clin Oncol,2011,16(5):613-616.
• [11]周战英.替吉奥联合奥沙利铂治疗晚期胃癌的近期疗效[J].临床医学,2016,36(6):66-67.
• [12]SHIRASAKA T,SHIMAMOTO Y,FUKUSHIMA M.Inhibition by oxonic acid of gastrointestinal toxicity of 5-fluorouracil without loss of its antitumor activity in rats[J].Cancer Res,1993,53(17):4004-4009.
• [13]FURUSE J,OKUSAKA T,KANEKO S,et al.PhaseⅠ/Ⅱstudy of the pharmacokinetics,safety and efficacy of S-1in patients with advanced hepatocellular carcinoma[J].Cancer Sci,2010,101(12):2606-2611.
• [14]郭晓光,王虎明.替吉奥联合TACE序贯肝动脉灌注奥沙利铂治疗转移性肝癌的临床研究[J].中国临床研究,2015,28(5):559-562.
• [15]黄伍奎,由丽娜,王萍菊,等.TACE联合替吉奥治疗肝癌的肝功能损伤及并发症分析[J].世界最新医学信息文摘,2016,16(18):10-13.