本文關(guān)鍵詞：口服替吉奧聯(lián)合TACE對BCLC B期原發(fā)性肝癌療效的回顧性分析　出處：《南昌大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： BCLC B期肝癌 TACE 替吉奧 預(yù)后因素

【摘要】：目的:觀察BCLC B期肝癌患者替吉奧聯(lián)合TACE方案近期有效率、TTP及毒副作用,并與單純TACE治療相比較。為BCLC B期肝癌患者臨床治療的方案選擇提供參考。方法:對我院2012年9月至2013年8月收治的BCLC B期原發(fā)性肝癌患者臨床及隨訪資料進(jìn)行回顧性分析,共統(tǒng)計了54例患者,其中25例接受了TACE(奧沙利鉑100-200mg、THP20-40mg)聯(lián)合口服替吉奧膠囊40mg/m2 Bid d1-14治療方案(A組),29例接受了TACE(奧沙利鉑100-200mg、THP20-40mg、5-FU 1.0g)方案治療(B組)。Bolondi L[1]等根據(jù)“Up to 7”標(biāo)準(zhǔn)(即瘤體數(shù)+最大腫瘤長徑≤7)及Child-Pugh評分將BCLC B期分為4個亞分期,分別將A組患者分為AB1-AB4亞組(分別對應(yīng)于BCLC B1-B4期),B組患者分為BB1-BB4亞組(分別對應(yīng)于BCLC B1-B4期)。利用SPSS17.0統(tǒng)計軟件對兩組患者的客觀緩解率、疾病控制率、TTP及不良反應(yīng)進(jìn)行分析,療效評價采用m RECIST[2]標(biāo)準(zhǔn)。并選用COX比例風(fēng)險模型對TTP預(yù)后因素行多因素分析。結(jié)果:本研究共納入54例患者的資料,其中25例接受了A組方案治療,29例接受了B組方案治療。全組ORR(客觀緩解率)為59.3%,DCR(疾病控制率)為85.2%,中位TTP為5.9個月。各組ORR分別為:A組為68%,B組為51.7%,DCR分別為:A組為92%,B組為79.4%,各組m TTP分別為:A組為6.8個月,B組為4.2個月。其中A組患者ORR及DCR較B組患者均有受益趨勢,但結(jié)果無統(tǒng)計學(xué)差異(P0.05),A組m TTP較B組明顯延長(P=0.035),亞組分析提示A(B2-B4)與B(B2-B4)期患者相比較,m TTP有所延長,差異有統(tǒng)計學(xué)意義(P=0.044)。治療相關(guān)不良反應(yīng)可耐受。多因素分析顯示影響TTP的因素包括近期療效(DCR)以及“Up to 7”。結(jié)論:本研究首次報道了替吉奧聯(lián)合TACE治療BCLC B期原發(fā)性肝癌的療效及安全性。替吉奧聯(lián)合TACE方案近期療效好且不良反應(yīng)可耐受,在保留TACE中其他藥物灌注和栓塞的基礎(chǔ)上,用口服替吉奧取代氟尿嘧啶動脈灌注,可進(jìn)一步延長患者TTP,初步結(jié)果表明,替吉奧聯(lián)合TACE方案更有益于超過“Up to 7”范圍的肝癌患者,延長TTP時間。
[Abstract]:Objective: To observe the BCLC B S-1 in patients with hepatocellular carcinoma combined with TACE regimen for the efficiency, TTP and side effects, and compared with TACE alone. It provides a reference for the choice of clinical treatment options for BCLC B patients with liver cancer. Methods: in our hospital from September 2012 to August 2013 were BCLC B in patients with primary liver cancer clinical and follow-up data were retrospectively analyzed. There were 54 cases of patients, 25 cases underwent TACE (oxaliplatin, THP20-40mg capsule 40mg/m2 Bid 100-200mg) d1-14 therapy combined with oral S-1 (A group), 29 cases accepted TACE (100-200mg THP20-40mg, 5-FU 1.0g, oxaliplatin) treatment (group B). Bolondi L[1] according to the "Up to 7" standard (i.e., tumor number and maximum tumor diameter less than or equal to 7) and the Child-Pugh score BCLC B divided into 4 sub stages, respectively, group A patients were divided into AB1-AB4 group (respectively BCLC B1-B4), group B patients were divided into BB1-BB4 subgroup (corresponding to BCLC B1-B4). The SPSS17.0 statistical software was used to analyze the objective remission rate, disease control rate, TTP and adverse reaction of the two groups of patients. The evaluation of the curative effect was based on the m RECIST[2] standard. The COX proportional risk model was used to analyze the prognostic factors of TTP. Results: a total of 54 patients were included in this study, of which 25 were treated with group A and 29 were treated with group B. The total group ORR (objective remission rate) was 59.3%, the DCR (disease control rate) was 85.2%, and the median TTP was 5.9 months. The ORR group was 68% in group A, 51.7% in group B, and 92% in group A and 79.4% in group B. The m TTP in each group was 6.8 months, and B group was 4.2 months. ORR and DCR in group A were all more beneficial than those in group B, but the results were not statistically different (P0.05). The m TTP in A group was significantly longer than that in B group (P=0.035), and subgroup analysis showed that A (P=0.035) had a longer prolongation compared with those in patients with stage II (phase). The treatment related adverse reactions were tolerable. Multivariate analysis showed that the factors affecting TTP included short-term efficacy (DCR) and "Up to 7". Conclusion: This is the first report of S-1 combined with TACE treatment efficacy and safety of BCLC B in primary hepatocellular carcinoma. S-1 combined with TACE regimen for the good curative effect and adverse reactions can be tolerated, in the retention of TACE in other drug perfusion and embolization, arterial infusion fluorouracil replaced with oral s-1, can further prolong the TTP, preliminary results show that the TACE scheme is more beneficial to Oteracil than "Up to 7" range of liver cancer patients, extended TTP time.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R735.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 丁曉燕;陳京龍;孫巍;郭曉笛;李文東;王湘漪;李麗;;低劑量白介素-2聯(lián)合肝動脈化療栓塞術(shù)序貫CT引導(dǎo)下射頻消融術(shù)在≥5cm的原發(fā)性肝癌的療效和安全性[J];臨床藥物治療雜志;2014年03期

2 范文哲;楊建勇;呂明德;謝曉燕;殷曉煜;黃勇慧;匡銘;李鶴平;徐輝雄;李家平;;TACE聯(lián)合經(jīng)皮熱消融治療大肝癌的療效及預(yù)后分析[J];中華醫(yī)學(xué)雜志;2011年31期

3 ;Expression of plasma vascular endothelial growth factor in patients with hepatocellular carcinoma and effect of transcatheter arterial chemoembolization therapy on plasma vascular endothelial growth factor level[J];World Journal of Gastroenterology;2004年19期

4 李欣,鄭傳勝,馮敢生,周承凱,柳曦;化療栓塞后VEGF的表達(dá)及其與微血管密度和細(xì)胞增殖關(guān)系的實驗研究[J];臨床放射學(xué)雜志;2004年02期

，

本文編號：1338683