CAJ | 학술논문

目的：评价经导管动脉内化疗栓塞（ TACE）联合贝伐单抗治疗不可切除结直肠肝转移癌的临床疗效。方法将120例不可切除结直肠肝转移癌的患者随机分为TACE治疗组（40例）、贝伐单抗治疗组（40例）、TACE联合贝伐单抗治疗组（40例），观察这三组患者肿瘤大小、免疫功能、血清肿瘤标志物及患者生存情况等指标。结果 TACE联合贝伐单抗治疗后，T淋巴细胞CD4＋、CD8＋细胞数CD4＋、CD8＋较治疗前显著升高（P＜0．05），CD4＋／CD8＋的差异均无统计学意义；联合治疗中CEA、CA 199水平显著下降（ P＜0．05），肿瘤生长明显受抑制，坏死范围较另两组大；且TACE联合贝伐单抗组患者3年生存率显著高于TACE组、贝伐单抗组（P＜0．05），TACE组与贝伐单抗组3年生存率比较差异无统计学意义。40例TACE联合贝伐单抗患者完全缓解0例、部分缓解16例、稳定20例、肿瘤进展4例，中位生存期为27．3个月，比二者单独治疗时控制肿瘤发展效果更佳。结论 TACE联合贝伐单抗治疗不能手术切除的结直肠癌肝转移时，相比较于TACE或贝伐单抗单独治疗更能有效抑制肝转移瘤的生长，延长患者生存时间，具有一定的临床应用价值。
목적：평개경도관동맥내화료전새（ TACE）연합패벌단항치료불가절제결직장간전이암적림상료효。방법장120례불가절제결직장간전이암적환자수궤분위TACE치료조（40례）、패벌단항치료조（40례）、TACE연합패벌단항치료조（40례），관찰저삼조환자종류대소、면역공능、혈청종류표지물급환자생존정황등지표。결과 TACE연합패벌단항치료후，T림파세포CD4＋、CD8＋세포수CD4＋、CD8＋교치료전현저승고（P＜0．05），CD4＋／CD8＋적차이균무통계학의의；연합치료중CEA、CA 199수평현저하강（ P＜0．05），종류생장명현수억제，배사범위교령량조대；차TACE연합패벌단항조환자3년생존솔현저고우TACE조、패벌단항조（P＜0．05），TACE조여패벌단항조3년생존솔비교차이무통계학의의。40례TACE연합패벌단항환자완전완해0례、부분완해16례、은정20례、종류진전4례，중위생존기위27．3개월，비이자단독치료시공제종류발전효과경가。결론 TACE연합패벌단항치료불능수술절제적결직장암간전이시，상비교우TACE혹패벌단항단독치료경능유효억제간전이류적생장，연장환자생존시간，구유일정적림상응용개치。
Objective To evaluate the clinical efficacy of transcatheter arterial chemoembolization ( TACE ) combined with bevacizumab in the treatment of unresectable colorectal carcinoma with hepatic metastases .Methods 120 cases of unresect-able colorectal carcinoma with hepatic metastases were randomly divided into TACE group (n=40),bevacizumab group (n=40),TACE and bevacizumab combination group (n=40).Tumor size,immune function,serum tumor markers and survival func-tions after treatment were observed in the 3 groups.Results In the combination group ,after the treatment with TACE and bevaci-zumab,CD4+and CD8+increased significantly (P<0.05),but CD4+/CD8+had no significant difference.In the combined treatment group,CEA、CA 199 decreased significantly (P<0.05),the growth of tumor size were significantly suppressed ,and necrosis area appeared larger than the other 2 groups.Moreover,the 3-year survival rate of the combination group was significantly higher than TACE group and bevacizumab group (P<0.05).There was 0 case of complete remission,16 cases of partial remis-sion,20 cases of stability and 4 cases of tumor progression in 40 patients who undergone combined treatment .The median survival time was 27.3 months.The combination treatment could control the progress of tumor growth .Conclusion For unresectable colo-rectal carcinoma with hepatic metastases ,TACE combined with bevacizumab is more effective than conventional TACE or bevaci -zumad only,it should be recommended in clinical practice .