三氧化二砷化疗对肝癌患者肝移植术后患者生存期的影响

季峻松; 陈婷; 王辉; 王晨怡; 朱心颖; 殷浩; 傅志仁

doi:10.3969/j.issn.1001-5256.2017.09.023

三氧化二砷化疗对肝癌患者肝移植术后患者生存期的影响

DOI: 10.3969/j.issn.1001-5256.2017.09.023

1. 上海长征医院闸北分院肝移植科
2. 上海长征医院肝移植科

基金项目:

上海市闸北区科研课题(青年2013QN03)；

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2017-03-06
- 出版日期: 2017-09-20

Effect of arsenic trioxide chemotherapy on survival time in liver cancer patients undergoing liver transplantation

Department of Liver Transplantation, Zhabei Branch of Changzheng Hospital

Research funding:

摘要

摘要: 目的探讨原发性肝癌肝移植术后给予三氧化二砷预防性化疗延长患者生存期的疗效。方法回顾性分析在长征医院肝移植科2005年1月-2015年12月行肝移植手术患者的临床资料,其中35例患者（对照组）采用表阿霉素D1+5-氟脲嘧啶（D1-5）的方案化疗,35例患者（观察组）采用三氧化二砷（D1-14）的方案化疗。每周期治疗开始及结束时进行血液学检查（包括血常规、肝肾功能、肿瘤指标等）,了解药物副作用;每2周期治疗开始时进行胸部CT、肝脏CT或MRI检查,记录患者肿瘤复发情况、生存状况及死亡时间。计数资料组间比较采用χ2检验,利用Kaplan-Meier法绘制生存曲线,并用log-rank检验比较2组生存曲线的差异。结果观察组仅有3例患者最后1次化疗后出现ALT一过性升高,积极保肝治疗后好转;30例患者在治疗后期均出现面部、下肢轻度浮肿等水钠滁留症状,利尿治疗及疗程结束后均能自行好转;对照组有24例患者曾有过不同程度的胃纳减少,恶心呕吐等消化道反应,但在化疗结束后均能好转。对照组1年生存率85.7%（30/35）、2年生存率47.4%（18/35）、3年生存率22.9%（8/...
- 砷剂 /
- 肝肿瘤 /
- 肝移植 /
- 预后
Abstract: Objective To investigate whether arsenic trioxide preventive chemotherapy can prolong the survival time of patients with primary liver cancer undergoing liver transplantation. Methods A retrospective analysis was performed for the clinical data of the patients who underwent liver transplantation in Department of Liver Transplantation in Changzheng Hospital from January to December, 2015, and among these patients, 35 ( observation group) received the chemotherapeutic regimen of epirubicin D1 + 5-fluorouracil ( D1-5) and 35 ( control group) received the chemotherapeutic regimen of arsenic trioxide ( D1-14) . Hematological examinations were performed at the beginning and ending of each cycle of treatment, including routine blood test, hepatic and renal function, and tumor markers, and drug side-effects were observed. Chest CT, liver CT, or MRI was performed at the beginning of every two cycles to record tumor recurrence, survival, and death time. The chi-square test was used for comparison of categorical data between groups, the Kaplan-Meier method was used to plot survival curves, and the log-rank test was used to compare survival curves between groups. Results In the observation group, 3 patients experienced a transient increase in alanine aminotransferase after the last chemotherapy; 30 patients experienced the symptoms of water-sodium retention including mild edema in the face and lower limbs in the late stage of treatment, which were improved after diuretic treatment or at the end of treatment. In the control group, 24 patients experienced varying degrees of gastrointestinal reactions such as poor appetite, nausea, and vomiting, which were improved at the end of chemotherapy. The control group had a 1-year survival rate of 85. 7% ( 30/35) , a 2-year survival rate of 47. 4% ( 18/35) , and a 3-year survival rate of 22. 9% ( 8/35) , and the observation group had a 1-year survival rate of 91. 4% ( 32/35) , a 2-year survival rate of 83. 9% ( 26/31) , and a 3-year survival rate of 57. 1% ( 12/21) . There was no significant difference in 1-year survival rate between the two groups ( χ2= 2. 258, P < 0. 05) , and the observation group had significantly higher 2-and 3-year survival rates than the control group ( χ2= 7. 786 and 6. 720, both P < 0. 05) . Survival curves also showed that the observation group had significantly higher 2-and 3-year survival rates than the control group ( χ2= 6. 573, P < 0. 05) . Conclusion Arsenic trioxide has been used for a long time, and with modern and scientific administration, it can improve the survival time of patients with liver cancer undergoing liver transplantation.
- arsenicals /
- liver neoplasms /
- liver transplantation /
- prognosis

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