CAJ | 학술논문

目的探讨吉西他滨热化疗灌注联合卡铂化疗栓塞术治疗原发性肝癌的价值.方法 96例肝癌患者随机数字表法分为两组,A组热化疗灌注联合肝动脉化疗栓塞术,B组常温下化疗灌注联合肝动脉化疗栓塞术.观察介入前后及介入后30 d患者肝肾功能、免疫功能变化；治疗后第30天行平扫加多期增强CT扫描,依实体肿瘤疗效评价标准(RECIST)比较两组临床有效率；间隔4～6周重复治疗1次,第3次介入治疗后随访,比较两组总生存期.结果治疗后第3天,两组丙氨酸氨基转移酶(ALT)及天冬氨酸氨基转移酶(AST)较治疗前均升高[A组ALT:(43±5)U/L比(84± 12)U/L,B组ALT:(41±3)U/L比(175± 10)U/L,A组AST:(44±2)U/L比(94±11)U/L,B组AST:(42±1)U/L比(173± 13)U/L,均P＜0.05],B组高于A组(P值分别为0.001,0.002),但治疗后第30天较治疗前无变化[A、B组ALT:(42±6)、(40±5)U/L,A、B组AST:(45±1)、(41±3)U/L,均P＜0.05].两组肾功能治疗前后无明显变化.A组CD；细胞及活化T细胞较治疗前升高[(69.35±6.88)％比(72.23±6.84)％,(11.83±4.09)％比(14.17±3.92)％,P值分别为0.005,0.002],而CD；细胞较治疗前下降[(24.18±1.85)％比(23.56±2.66)％,P=0.028].A组总有效率75.00％(36/48),B组39.58％(19/48),差异有统计学意义(P＜0.01).A组患者中位生存时间24.0个月(95％CI为20 ～ 29个月),B组为18.9个月(95％CI为18 ～ 20个月),差异有统计学意义(P＜0.01).结论吉西他滨热化疗灌注联合卡铂肝动脉化疗栓塞治疗原发性肝癌是治疗肝癌的一种安全、有效的方法,其对肝功能影响较小且呈一过性.
목적 탐토길서타빈열화료관주연합잡박화료전새술치료원발성간암적개치.방법 96례간암환자수궤수자표법분위량조,A조열화료관주연합간동맥화료전새술,B조상온하화료관주연합간동맥화료전새술.관찰개입전후급개입후30 d환자간신공능、면역공능변화；치료후제30천행평소가다기증강CT소묘,의실체종류료효평개표준(RECIST)비교량조림상유효솔；간격4～6주중복치료1차,제3차개입치료후수방,비교량조총생존기.결과 치료후제3천,량조병안산안기전이매(ALT)급천동안산안기전이매(AST)교치료전균승고[A조ALT:(43±5)U/L비(84± 12)U/L,B조ALT:(41±3)U/L비(175± 10)U/L,A조AST:(44±2)U/L비(94±11)U/L,B조AST:(42±1)U/L비(173± 13)U/L,균P＜0.05],B조고우A조(P치분별위0.001,0.002),단치료후제30천교치료전무변화[A、B조ALT:(42±6)、(40±5)U/L,A、B조AST:(45±1)、(41±3)U/L,균P＜0.05].량조신공능치료전후무명현변화.A조CD；세포급활화T세포교치료전승고[(69.35±6.88)％비(72.23±6.84)％,(11.83±4.09)％비(14.17±3.92)％,P치분별위0.005,0.002],이CD；세포교치료전하강[(24.18±1.85)％비(23.56±2.66)％,P=0.028].A조총유효솔75.00％(36/48),B조39.58％(19/48),차이유통계학의의(P＜0.01).A조환자중위생존시간24.0개월(95％CI위20 ～ 29개월),B조위18.9개월(95％CI위18 ～ 20개월),차이유통계학의의(P＜0.01).결론 길서타빈열화료관주연합잡박간동맥화료전새치료원발성간암시치료간암적일충안전、유효적방법,기대간공능영향교소차정일과성.
Objective To assess the therapeutic effect of thermochemotherapy infusion combined with chemoembolization in the treatment of primary hepatocellular carcinoma.Methods Ninty six patients with hepatic carcinoma were randomly diveded into two groups.In A group,the patients underwent thermochemotherapy infusion combined with chemoembolization.In B group,chemotherapy infusion was done combined with chemoembolization.Before the therapy,the basic examinations of patients were improved,including liver function,renal function,immune function.At the same time,each patient was performed with enhanced CT scan.Three days and a month after treatment,main outcome measures,containing liver function,renal function,and immune function were examined,the volumes of tumor were measured on CT.Repeat treatment were performed between four and six weeks.Follow-up was performed after the third treatment,patients survival periods were observed.Results A and B groups of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were higher than pre-treatment after 3 days (all P ＜ 0.05),but the ALT and AST in group B were both higher than those in group A (P =0.001,P =0.002),there were no changes after 30 days.No significant difference of renal function were found in the both groups.In the A group,the total efficiency was 75.00 ％ (36/48),and that of the B group was 39.58 ％ (19/48),showing statistically significant difference (P ＜ 0.01).In the A group,the immunity state of patients were improved after treatment.In the A group,the median survival time was 24.0 months (95 ％ CI was 20-29 months).In the B group,the median survival time was 18.9 months (95 ％ CI was 18-20 months).There was significant difference between the two groups (P ＜ 0.01).Conclusion The gemcitabine transcatheter arterial heated chemotherapy combined carboplatin with transcatheter arterial chemoembolization is effective treatment for primary hepatocellular carinoma.