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微球经肝动脉化疗栓塞术联合放疗治疗不可切除肝癌的有效性和安全性分析
Efficacy and safety of microsphere transarterid chemoembolization combined with radiotherapy versus microsphere transarterial chemoembolization alone in treatment of patients with unresectable liver cancer
文章发布日期:2019年09月29日  来源:  作者:马洺远,林纲毅,蔡宗洋,等  点击次数:283次  下载次数:53次

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【摘要】: 目的 探讨微球经肝动脉化疗栓塞术(TACE)联合放疗治疗不可切除肝癌的有效性和安全性。方法 选取2016年1月-2018年10月在汕头市中心医院接受治疗的原发性肝癌患者68例,随机分为微球TACE组(n=34),微球TACE联合放疗组(n=34),比较两组患者近期有效率和无进展生存率、总生存率的差异,同时比较两组患者的不良反应,评估治疗的安全性。计数资料组间比较采用χ2检验,两组患者无进展生存率和总生存率的比较采用Kaplan-Meier法和Log-Rank检验。结果 截止至末次随访2019年4月30日,所有患者均完成计划治疗,中位随访15.2个月,死亡25例。微球TACE组客观缓解率为50.0%,微球TACE联合放疗组客观缓解率为76.5%,微球TACE联合放疗组的近期疗效优于微球TACE组(χ2=7.995,P=0.046)。微球TACE组6、12、18和24个月的总生存率和无进展生存率分别为94.1%和76.5%,69.0%和47.1%,51.3%和23.9%,30.9%和9.6%,微球TACE联合放疗组6、12、18和24个月的总生存率和无进展生存率分别100%和93.7%,87.8%和81.1%,75.1%和52.9%,58.2%和44.1%,微球TACE联合放疗组患者无进展生存时间和总生存时间显著优于微球TACE组(χ2分别为9.027、4.288,P值分别为0.002 7、0.038)。两组患者不良反应发生率低,无治疗相关死亡事件。结论 与微球TACE治疗相比,微球TACE联合放疗显著改善了不可切除肝癌治疗的近期疗效和远期生存,为这一类的肝癌患者提供了一种更优效和安全的治疗方法。
【Abstract】: Objective To investigate the efficacy and safety of microsphere transarterial chemoembolization (TACE) combined with radiotherapy in the treatment of patients with unresectable liver cancer. Methods A total of 68 patients with unresectable liver cancer were enrolled in Shantou central hospital from January 2016 to October 2018, among whom there were 65 male and 3 female patients, with a median age of 55 years (range 36-75 years). These patients were randomly divided into microsphere TACE group with 34 patients and microsphere TACE combined with radiotherapy group (combined group with 34 patients). The two groups were compared in terms of short-term response rate, progression-free survival (PFS) rate, overall survival (OS) rate, and adverse events to evaluate safety. The chi-square test was used for comparison of categorical data between groups, and the Kaplan-Meier method and the log-rank test were used for comparison of PFS and OS rates. Results Up to the last follow-up on April 30, 2019, all patients completed treatment as planned and the median follow-up time was 15.2 months. A total of 25 deaths were observed. The objective response rate was 50.0% in the microsphere TACE group and 76.5% in the combined group, and the combined group had a significantly better short-term response than the microsphere TACE group (χ2=7.995, P=0.046). For the microsphere TACE group, the 6-, 12-, 18-, and 24-month OS and PFS rates were 94.1%/76.5%, 69.0%/47.1%, 51.3%/23.9%, and 30.9%/9.6%, respectively, and for the combined group, the 6-, 12-, 18-, and 24-month OS and PFS rates were 100%/93.7%, 87.8%/81.1%, 75.1%/52.9%, and 58.2%/44.1%, respectively; the combined group had significantly better PFS and OS time than the microsphere TACE group (χ2=9.027 and 4.288, P=0.002 7 and 0.038). There was a low incidence rate of adverse events in the two groups, and no treatment-related death was observed. Conclusion Compared with microsphere TACE alone, microsphere TACE combined with radiotherapy significantly improves short-term response and long-term survival in patients with unresectable liver cancer and thus provides a more effective and safer treatment for such patients.
【关键字】:肝肿瘤; 化学栓塞, 治疗性; 放射疗法
【Key words】:liver neoplasms; chemoembolization, therapeutic; radiotherapy
【引证本文】:MA MY, LIN GY, CAI ZY, et al. Efficacy and safety of microsphere transarterial chemoembolization combined with radiotherapy versus microsphere transarterial chemoembolization alone in treatment of patients with unresectable liver cancer[J]. J Clin Hepatol, 2019, 35(11): 2489-2494. (in Chinese)
马洺远, 林纲毅, 蔡宗洋, 等. 微球经肝动脉化疗栓塞术联合放疗治疗不可切除肝癌的有效性和安全性分析[J]. 临床肝胆病杂志, 2019, 35(11): 2489-2494.

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