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目的评价雷替曲塞联合经肝动脉化疗栓塞术在治疗晚期大肠癌肝转移中的疗效。方法选取中国石油天然气集团公司中心医院2012年1月~(-2)015年6月收治的大肠癌术后晚期肝转移的患者80例,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介入下肝动脉灌注化疗联合栓塞治疗,对照组给予静脉输注雷替曲塞单药治疗。以上治疗每4周1次,共进行3~6个周期。观察2组的治疗有效率(RR)、疾病控制率(DCR)、中位疾病进展时间、生存率以及癌胚抗原(CEA)、糖链抗原(CA)19-9、转氨酶、胆红素的下降情况。计数资料组间比较采用χ~2检验,生存分析采用Kaplom-Meier法。结果研究组的RR与对照组(45.0%vs 22.5%)比较,差异有统计学意义(χ~2=4.528,P=0.033);研究组的DCR与对照组(70.0%vs 47.5%)比较,差异有统计学意义(χ~2=4.178,P=0.041)。研究组的中位疾病进展时间与对照组(17.9个月vs 10.5个月)比较,差异有统计学意义(χ~2=24.08,P<0.001)。研究组的1、2年生存率分别为80.0%、55.0%,对照组的分别为57.5%、32.5%,2组比较,差异均有统计学意义(χ~2值分别为4.713、4.114,P值分别为0.030、0.043)。研究组化疗栓塞术后2个月的CA19-9、CEA、转氨酶、胆红素水平下降超过50%的病例数均较对照组多,差异均有统计学意义(χ~2值分别为5.333、4.528、5.051、5.013,P值分别为0.021、0.033、0.025、0.025)。结论雷替曲塞联合经肝动脉化疗栓塞术在治疗晚期大肠癌肝转移中有一定的价值,值得临床推广。
Objective To evaluate the efficacy of ralterexed in combination with transcatheter arterial chemoembolization in the treatment of advanced liver cancer with colorectal cancer. Methods Eighty patients with postoperative late liver metastases of colorectal cancer admitted from January 2012 to (-2) 015 in Central Hospital of China National Petroleum Corporation were selected and randomly divided into study group and control group example. The study group received raltitrexed interventional hepatic arterial infusion chemotherapy combined with embolization, while the control group received intravenous infusion of raltitrexed monotherapy. 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 and carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, aminotransferase, bilirubin Declining situation. Count data between groups using χ ~ 2 test, survival analysis using Kaplom-Meier method. Results Compared with the control group (45.0% vs 22.5%), the RR of the study group was significantly different (χ ~ 2 = 4.528, P = 0.033). Compared with the control group (70.0% vs 47.5% The difference was statistically significant (χ ~ 2 = 4.178, P = 0.041). The median time to progression in the study group was statistically different from the control group (17.9 months vs 10.5 months) (χ ~ 2 = 24.08, P <0.001). The 1-year and 2-year survival rates were 80.0% and 55.0% in the study group and 57.5% and 32.5% in the control group respectively, with significant differences between the two groups (χ ~ 2 values were 4.713 and 4.141 respectively, P Values were 0.030,0.043). The number of cases in which the levels of CA19-9, CEA, aminotransferase and bilirubin decreased by more than 50% at 2 months after chemoembolization in the study group were significantly higher than those in the control group (χ ~ 2 = 5.333, 4.528, 5.051, 5.013, P values were 0.021,0.033,0.025,0.025, respectively). Conclusion raltitrexed in combination with transcatheter hepatic artery chemoembolization has certain value in the treatment of advanced colorectal cancer liver metastasis and is worthy of clinical promotion.