中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
2期
107-110
,共4页
癌,肝细胞%氟尿嘧啶%存活率%抗肿瘤联合化疗方案
癌,肝細胞%氟尿嘧啶%存活率%抗腫瘤聯閤化療方案
암,간세포%불뇨밀정%존활솔%항종류연합화료방안
Carcinoma,hepatocellular%Fluorouracil%Survival rate%Antineoplastic combined chemotherapy protocols
目的 探讨肝癌根治术中植入氟尿嘧啶缓释剂的安全性及其对无瘤生存率和总体生存率的影响.方法 收集2008年1月至2009年1月完成肝癌根治手术的患者59例,按术中有无使用氟尿嘧啶缓释剂分为治疗组(24例)和对照组(35例),两组患者术后均未予其他化疗.检测两组患者术前1天、术后3周的白细胞、肝功能、AFP;术后半年内每月、半年后每3个月复查AFP及影像学,对可疑复发的患者行CT引导下穿刺活检确诊,统计术后6、12、18、24个月的无瘤生存率和总体生存率.结果 术后3周治疗组WBC、ALT、AST、TBIL,与对照组差异无统计学意义(分别t=0.801、-0.854、- 1.948、- 0.503,均P＞0.05).治疗组术前、术后3周、术后6个月AFP为(361.58±431.06) μg/L、(17.02±15.55)μg/L、(43.61±58.03) μg/L,对照组为(495.50±441.63) μg/L、(26.82±60.46) μg/L、(127.48±229.79) μg/L.术后6个月治疗组明显低于对照组(t=-2.065,P＜0.05).治疗组术后6、12、18、24个月的无瘤生存率为95.8％、91.7％、79.2％、75.0％,对照组为94.3％、71.4％、60.0％、48.6％(Log rank检验x2=4.035,P＜0.05)；治疗组术后6、12、18、24个月的总体生存率为100％、95.8％、91.7％、83.3％,对照组为100％、94.3％、77.1％、60.0％(Log rank检验x2=3.931,P＜1.05).结论 术中植入氟尿嘧啶缓释剂具有良好的安全性,是降低肝癌复发率、延长患者生存期的有效方法.
目的 探討肝癌根治術中植入氟尿嘧啶緩釋劑的安全性及其對無瘤生存率和總體生存率的影響.方法 收集2008年1月至2009年1月完成肝癌根治手術的患者59例,按術中有無使用氟尿嘧啶緩釋劑分為治療組(24例)和對照組(35例),兩組患者術後均未予其他化療.檢測兩組患者術前1天、術後3週的白細胞、肝功能、AFP;術後半年內每月、半年後每3箇月複查AFP及影像學,對可疑複髮的患者行CT引導下穿刺活檢確診,統計術後6、12、18、24箇月的無瘤生存率和總體生存率.結果 術後3週治療組WBC、ALT、AST、TBIL,與對照組差異無統計學意義(分彆t=0.801、-0.854、- 1.948、- 0.503,均P＞0.05).治療組術前、術後3週、術後6箇月AFP為(361.58±431.06) μg/L、(17.02±15.55)μg/L、(43.61±58.03) μg/L,對照組為(495.50±441.63) μg/L、(26.82±60.46) μg/L、(127.48±229.79) μg/L.術後6箇月治療組明顯低于對照組(t=-2.065,P＜0.05).治療組術後6、12、18、24箇月的無瘤生存率為95.8％、91.7％、79.2％、75.0％,對照組為94.3％、71.4％、60.0％、48.6％(Log rank檢驗x2=4.035,P＜0.05)；治療組術後6、12、18、24箇月的總體生存率為100％、95.8％、91.7％、83.3％,對照組為100％、94.3％、77.1％、60.0％(Log rank檢驗x2=3.931,P＜1.05).結論 術中植入氟尿嘧啶緩釋劑具有良好的安全性,是降低肝癌複髮率、延長患者生存期的有效方法.
목적 탐토간암근치술중식입불뇨밀정완석제적안전성급기대무류생존솔화총체생존솔적영향.방법 수집2008년1월지2009년1월완성간암근치수술적환자59례,안술중유무사용불뇨밀정완석제분위치료조(24례)화대조조(35례),량조환자술후균미여기타화료.검측량조환자술전1천、술후3주적백세포、간공능、AFP;술후반년내매월、반년후매3개월복사AFP급영상학,대가의복발적환자행CT인도하천자활검학진,통계술후6、12、18、24개월적무류생존솔화총체생존솔.결과 술후3주치료조WBC、ALT、AST、TBIL,여대조조차이무통계학의의(분별t=0.801、-0.854、- 1.948、- 0.503,균P＞0.05).치료조술전、술후3주、술후6개월AFP위(361.58±431.06) μg/L、(17.02±15.55)μg/L、(43.61±58.03) μg/L,대조조위(495.50±441.63) μg/L、(26.82±60.46) μg/L、(127.48±229.79) μg/L.술후6개월치료조명현저우대조조(t=-2.065,P＜0.05).치료조술후6、12、18、24개월적무류생존솔위95.8％、91.7％、79.2％、75.0％,대조조위94.3％、71.4％、60.0％、48.6％(Log rank검험x2=4.035,P＜0.05)；치료조술후6、12、18、24개월적총체생존솔위100％、95.8％、91.7％、83.3％,대조조위100％、94.3％、77.1％、60.0％(Log rank검험x2=3.931,P＜1.05).결론 술중식입불뇨밀정완석제구유량호적안전성,시강저간암복발솔、연장환자생존기적유효방법.
Objective To study the safety and efficacy of intraoperative implanting slow-released 5-Fu after hepatectomy in patients with hepatocellular carcinoma (HCC). Methods 59 HCC patients undergoing hepatectomy from January 2008 to January 2009 were divided into two groups:to receive slowrelaesed 5-Fu in treatment group and nothing in control group.Postoperatively no patients in both group took chemotherapy.The serous value of WBC,ALT,AST,TBIL and AFP were measured in all cases on 1 day before and 3 weeks after the operation.During the first six months,AFP was measured and imaging studies were done one month after discharge,and every 3 months since then.CT-guided biopsy was used to confirm the recurrence of HCC. Disease-free survival rate and overall survival rate in two groups calculated respectively 6-,12-,18- and 24-months after the operation. Results The serous value of WBC,ALT,AST,TBIL was not different between treatment group and control group 3 weeks after the operation (separately t =0.801,- 0.854,- 1.948,- 0.503,all P ＞ 0.05).AFP was (361.58 ± 431.06) μg/L,( 17.02 ± 15.55 ) μg/L,(43.61 ± 58.03 ) μg/L in treatment group and (495.50 ± 441.63 ) μg/L,(26.82 ±60.46) μg/L,(127.48 ±229.79) μg/L in control group preoperatively,3 weeks and 6 months after the operation.AFP was lower in treatment group than that in control group ( t =- 2.065,P ＜ 0.05 ).The disease-free survival rate in treatment group was 95.8％,91.7％,79.2％,75.0％ at 6-,12-,18- and 24-months after the operation,in control group it was 94.3％,71.4％,60.0％,48.6％ ( x2 =4.035,P ＜0.05).The overall survival rate was respectively 100％,95.8％,91.7％,83.3％ in treatment group and was 100％,94.3％,77.1％,60.0％ in control group( x2 =3.931,P ＜0.05).Conclusions Intraoperativeimplanting slow-released 5-Fu during the hepatectomy was safe and effective method to reduce the recurrence rate of hepatocellular carcinoma and prolongs postoperative disease free and overall survival in HCC patients undergoing hepatectomy.
