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目的探讨在常规支持治疗方法的基础上加用奥曲肽治疗晚期原发性肝癌的临床疗效。方法将60例晚期原发性肝癌患者随机分为观察组和对照组各30例,对照组采用常规的保肝支持治疗,包括给予止痛、利尿、护肝、纠正水电解质失衡、补充能量、抗感染等各项综合治疗措施;观察组在对照组治疗方法的基础上加用奥曲肽0.2mg皮下注射,每12h一次,连续治疗直到病情进展时停药。结果观察组CR1例,PR7例,SD14例,PD8例,总有效率26.7%,临床获益率73.3%。对照组SD11例,PD19例,总有效率0%,临床获益率36.7%。观察组中位生存期为7.5个月,对照组中位生存期为2.8个月。观察组中位疾病进展时间(TTP)3.8个月,对照组TTP为1.6个月。观察组患者生活质量增加5例,稳定12例,下降13例,良好者共计17例,良好率56.7%;对照组患者生活质量增加0例,稳定8例,下降22例,良好者共计8例,良好率26.7%。经统计学处理,观察组的疗效总有效率、临床获益率、中位生存期、中位疾病进展时间、生活质量良好率等指标均显著好于对照组(P<0.01或P<0.05)。观察组使用奥曲肽治疗后的不良反应很少,主要表现为恶心、呕吐以及皮下注射局部有疼痛,均仅为轻度,不需停药或特殊处理。结论在常规支持治疗方法的基础上加用奥曲肽能够有效延长晚期原发性肝癌能患者的生存期,提高生活质量,不良反应少,疗效确切。
Objective To investigate the clinical effect of adding octreotide on advanced primary hepatocellular carcinoma (HCC) based on routine supportive therapy. Methods Sixty patients with advanced primary liver cancer were randomly divided into observation group (30 cases) and control group (30 cases). The control group received routine hepatoprotective support including pain relief, diuresis, liver protection, water electrolyte imbalance, energy supplement, Infection and other comprehensive treatment measures; observation group in the control group on the basis of treatment plus octreotide 0.2mg subcutaneous injection, once every 12h, continuous treatment until the progression of the disease withdrawal. Results The observation group CR1 cases, PR7 cases, SD14 cases, PD8 cases, the total effective rate was 26.7%, the clinical benefit rate was 73.3%. The control group SD11 cases, PD19 cases, the total effective rate of 0%, the clinical benefit rate of 36.7%. The median survival time was 7.5 months in the observation group and 2.8 months in the control group. In the observation group, the median time to progression of disease (TTP) was 3.8 months, while the control group had a TTP of 1.6 months. In the observation group, the quality of life increased in 5 cases, stable in 12 cases, decreased in 13 cases, good in 17 cases, with a good rate of 56.7%. In the control group, the quality of life increased in 0 cases, stable in 8 cases, decreased in 22 cases, and good in 8 cases , A good rate of 26.7%. After statistical analysis, the total effective rate, clinical benefit rate, median survival time, median disease progression time and good quality of life of the observation group were significantly better than those of the control group (P <0.01 or P <0.05) . Adverse effects after octreotide treatment in the observation group were few, mainly manifested as nausea, vomiting and subcutaneous injection of local pain, were only mild, without stopping or special treatment. Conclusion The addition of octreotide on the basis of conventional supportive therapy can effectively prolong the survival of patients with advanced primary liver cancer, improve the quality of life, fewer adverse reactions, and definite curative effect.