口服替吉奥联合TACE对BCLC B期原发性肝癌疗效的回顾性分析

发布时间：2017-12-26 20:14

本文关键词：口服替吉奥联合TACE对BCLC B期原发性肝癌疗效的回顾性分析　出处：《南昌大学》2015年硕士论文　论文类型：学位论文

更多相关文章： BCLC B期肝癌 TACE 替吉奥 预后因素

【摘要】：目的:观察BCLC B期肝癌患者替吉奥联合TACE方案近期有效率、TTP及毒副作用,并与单纯TACE治疗相比较。为BCLC B期肝癌患者临床治疗的方案选择提供参考。方法:对我院2012年9月至2013年8月收治的BCLC B期原发性肝癌患者临床及随访资料进行回顾性分析,共统计了54例患者,其中25例接受了TACE(奥沙利铂100-200mg、THP20-40mg)联合口服替吉奥胶囊40mg/m2 Bid d1-14治疗方案(A组),29例接受了TACE(奥沙利铂100-200mg、THP20-40mg、5-FU 1.0g)方案治疗(B组)。Bolondi L[1]等根据“Up to 7”标准(即瘤体数+最大肿瘤长径≤7)及Child-Pugh评分将BCLC B期分为4个亚分期,分别将A组患者分为AB1-AB4亚组(分别对应于BCLC B1-B4期),B组患者分为BB1-BB4亚组(分别对应于BCLC B1-B4期)。利用SPSS17.0统计软件对两组患者的客观缓解率、疾病控制率、TTP及不良反应进行分析,疗效评价采用m RECIST[2]标准。并选用COX比例风险模型对TTP预后因素行多因素分析。结果:本研究共纳入54例患者的资料,其中25例接受了A组方案治疗,29例接受了B组方案治疗。全组ORR(客观缓解率)为59.3%,DCR(疾病控制率)为85.2%,中位TTP为5.9个月。各组ORR分别为:A组为68%,B组为51.7%,DCR分别为:A组为92%,B组为79.4%,各组m TTP分别为:A组为6.8个月,B组为4.2个月。其中A组患者ORR及DCR较B组患者均有受益趋势,但结果无统计学差异(P0.05),A组m TTP较B组明显延长(P=0.035),亚组分析提示A(B2-B4)与B(B2-B4)期患者相比较,m TTP有所延长,差异有统计学意义(P=0.044)。治疗相关不良反应可耐受。多因素分析显示影响TTP的因素包括近期疗效(DCR)以及“Up to 7”。结论:本研究首次报道了替吉奥联合TACE治疗BCLC B期原发性肝癌的疗效及安全性。替吉奥联合TACE方案近期疗效好且不良反应可耐受,在保留TACE中其他药物灌注和栓塞的基础上,用口服替吉奥取代氟尿嘧啶动脉灌注,可进一步延长患者TTP,初步结果表明,替吉奥联合TACE方案更有益于超过“Up to 7”范围的肝癌患者,延长TTP时间。
[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.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.7

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