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目的评价雷替曲塞联合表柔比星介入肝动脉灌注化疗栓塞在治疗中晚期原发性肝癌中的疗效。方法选取中国石油天然气集团公司中心医院2011年1月-2013年5月收治的80例不适合手术治疗的中晚期原发性肝癌患者,将其随机分为研究组和对照组,每组40例。研究组给予雷替曲塞联合表柔比星介入下肝动脉灌注化疗栓塞治疗,对照组给予氟尿嘧啶(5-FU)联合表柔比星介入下肝动脉灌注化疗栓塞治疗。以上治疗每4周1次,共进行3~6周期。观察两组的治疗有效率(RR)、疾病控制率(DCR)、中位疾病进展时间、生存率以及甲胎蛋白(AFP)、癌胚抗原(CEA)、转氨酶、胆红素的下降情况。计数资料组间比较采用χ2检验,计量资料组间比较采用t检验。结果研究组的RR为52.5%,对照组为22.5%,差异均有统计学意义(χ2=7.680,P=0.006);研究组的DCR为87.5%,对照组为60.0%,差异有统计学意义(χ2=7.813,P=0.005);研究组的中位疾病进展时间为12.2个月,对照组为8.0个月,差异有统计学意义(t=5.118,P=0.00);研究组的1、2年生存率分别为为85.0%、60.0%,对照组分别为65.0%、37.5%,差异均有统计学意义(χ2值分别为4.267、4.053,P值分别为0.039、0.044);研究组化疗栓塞术后1个月AFP、转氨酶、胆红素水平下降超过50%的病例数均多于对照组,差异均具有统计学意义(χ2值分别为4.381、4.114、5.000,P值分别为0.036、0.043、0.025)。结论雷替曲塞联合表柔比星介入肝动脉灌注化疗栓塞对治疗中晚期原发性肝癌有一定价值,值得在临床中推广。
Objective To evaluate the efficacy of raltetracetam and epirubicin in the treatment of advanced primary hepatocellular carcinoma (HCC) treated with transcatheter arterial chemoembolization. Methods A total of 80 patients with advanced primary hepatocellular carcinoma who were not suitable for surgical treatment admitted to the Central Hospital of China National Petroleum Corporation from January 2011 to May 2013 were selected and randomly divided into study group and control group with 40 cases in each group . The study group received raltitrexed epirubicin in combination with hepatic arterial chemoembolization and the control group received fluorouracil (5-FU) combined with epirubicin in the interventional hepatic arterial chemoembolization. The above treatment once every 4 weeks, a total of 3 to 6 cycles. The treatment efficiency (RR), disease control rate (DCR), median disease progression time, survival rate, as well as the decline of AFP, CEA, aminotransferase and bilirubin were observed. Count data between groups using χ2 test, measurement data between groups using t test. Results The RR of the study group was 52.5% and that of the control group was 22.5% (χ2 = 7.680, P = 0.006). The DCR of the study group was 87.5% and that of the control group was 60.0%, the difference was statistically significant (χ2 = 7.813, P = 0.005). The median progression time of the study group was 12.2 months and 8.0 months in the control group (t = 5.118, P = 0.00) The 2-year survival rates were 85.0% and 60.0% in the control group and 65.0% and 37.5% in the control group respectively (χ2 = 4.267 and 4.053, P = 0.039 and 0.044, respectively) One month after embolization, the number of AFP, transaminase and bilirubin decreased more than 50% in the control group, the differences were statistically significant (χ2 = 4.381,4.114,5.000, P = 0.036, 0.043, 0.025). Conclusions Raltitrexed and epirubicin interventional chemotherapy with hepatic arterial chemoembolization may have some value in the treatment of advanced primary liver cancer. It is worth to be popularized in clinic.