替吉奥治疗原发性肝癌根治术后循环肿瘤细胞阳性患者的效果观察

王春梅; 曾建挺; 罗鲜樟; 刘亚

doi:10.3969/j.issn.1001-5256.2018.03.012

替吉奥治疗原发性肝癌根治术后循环肿瘤细胞阳性患者的效果观察

DOI: 10.3969/j.issn.1001-5256.2018.03.012

重庆大学附属肿瘤医院，重庆市肿瘤研究所，重庆市肿瘤医院肿瘤内科

基金项目:

重庆市卫计委面上项目(2016MSXM085)；

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2017-09-26
- 出版日期: 2018-03-20

Clinical effect of S-1 in treatment of circulating tumor cell-positive patients after radical surgery for primary hepatic carcinoma

Department of Medical Oncology, The Affiliated Tumor Hospital of Chongqing University, Chongqing Cancer Institute & Chongqing Cancer Hospital,

Research funding:

摘要

摘要:
目的探索替吉奥治疗原发性肝癌（PHC）根治术后循环肿瘤细胞（CTC）阳性患者的效果。方法收集2014年6月-2016年1月重庆市肿瘤医院收治的PHC术后CTC阳性的患者56例。随机分为治疗组和对照组,每组28例。观察治疗后2组患者CTC数目变化、毒副作用、无瘤存活时间。计量资料2组间比较采用t检验,计数资料2组间比较采用χ2检验或Fisher精确检验,采用Kaplan-Meier法绘制生存曲线,2组存活率比较采用Breslow检验。结果治疗开始后2组在各检测时间点CTC数目分别为:3个月（2.1±1.2 vs 3.8±1.2）、6个月（1.9±1.3 vs 4.0±1.4）、12个月（1.5±1.2 vs 4.5±1.5）、18个月（1.6±1.4 vs 5.5±0.9）,差异均有统计学意义（t值分别为5.52、5.96、8.17、12.33、P值均<0.000 1）。治疗组在治疗后1个月CTC数目较治疗前明显降低（t=8.10,P<0.000 1）。对照组随着时间推移,CTC数目较前明显增多。治疗组无瘤存活时间较对照组明显延长（t=5.279,P=0...
- 肝肿瘤 /
- 循环肿瘤细胞 /
- 替吉奥 /
- 治疗结果
Abstract:
Objective To investigate the clinical effect of tegafur, gimeracil, and oteracil ( S-1) in the treatment of circulating tumor cell ( CTC) -positive patients after radical surgery for primary hepatic carcinoma ( PHC) . Methods A total of 56 CTC-positive patients after radical surgery for PHC who were admitted to Chongqing Cancer Hospital from June 2014 to January 2016 were enrolled and randomly divided into treatment group and control group, with 28 patients in each group. The two groups were observed in terms of the change in the number of CTCs after treatment, toxic and side effects, and disease-free survival time. The t-test was used for comparison of continuous data between groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups; the Kaplan-Meier method was used to plot survival curves and the Breslow test was used for comparison of survival rates between the two groups. Results There were significant differences in the number of CTCs between the two groups at 3 months ( 2. 1 ± 1. 2 vs 3. 8 ± 1. 2, t = 5. 52, P < 0. 000 1) , 6 months ( 1. 9 ± 1. 3 vs 4. 0 ± 1. 4, t = 5. 96, P < 0. 000 1) , 12 months ( 1. 5 ± 1. 2 vs 4. 5 ± 1. 5, t = 8. 17, P < 0. 000 1) , and 18 months ( 1. 6 ± 1. 4 vs 5. 5 ± 0. 9, t = 12. 33, P < 0. 000 1) after treatment. The treatment group had a significant reduction in the number of CTCs at one month after treatment ( t = 8. 10, P < 0. 000 1) . The control group had a significant increase in the number of CTCs over time. The treatment group had a significantly longer disease-free survival time than the control group ( t = 5. 279, P = 0. 021 6) , and there was a significant difference in the time to progression between the treatment group and the control group ( 11. 8 ± 2. 4 months vs 10. 8 ± 2. 3 months, t = 4. 31, P < 0. 05) . No patient died during the observation period. Five patients in the treatment group experienced adverse events, among whom 2 had gastrointestinal reaction, 2 had liver injury, and 1 had myelosuppression, and all of them were improved after symptomatic treatment, without any influence on the administration of therapeutic drugs. No patient experienced grade ≥III side effects. Conclusion S-1 can increase the disease-free survival time of CTC-positive patients after radical surgery for PHC and does not increase toxic and side effects.
- liver neoplasms /
- circulating tumor cell /
- oteracil /
- treatment outcome

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参考文献(10)

[1]FERLAY J, SHIN HR, BRAY F, et al.Estimates of worldwide Burden of Cancer in 2008:GLOBOCAN 2008[J].Int J Cancer, 2010, 127 (12) :2893-2917.

[2]TANG ZY.Studies on liver cancer:evolution and perspectives[J].J Clin Hepatol, 2014, 30 (3) :193-196. (in Chinese) 汤钊猷.肝癌研究的变迁与趋势[J].临床肝胆病杂志, 2014, 30 (3) :193-196.

[3]FENG JC, YANG B, DAI C, et al.Association of the number of circulating tumor cells and early recurrence in patients with hepatocellular carcinoma following liver transplantation[J].Chin J Organ Transplant, 2016, 37 (2) :76-80. (in Chinese) 冯锦城, 杨博, 代辰, 等.肝癌患者外周血中循环肿瘤细胞数量与肝移植后肿瘤早期复发的相关性研究[J].中华器官移植杂志, 2016, 37 (2) :76-80.

[4]SUN YF, XU Y, YANG XR, et al.Circulating stem cell-like epithelial cell adhesion molecule-positive tumor cells indicate poor prognosis of hepatocellular carcinoma after curative resection[J].Hepatology, 2013, 57 (4) :1458-1468.

[5]WANG JH, WANG CC, HUNG CH, et al.Survival comparison between surgical resection and radiofrequency ablation for patients in BCLC very early/early stage hepatocellular carcinoma[J].J Hepatol, 2012, 56 (2) :412-418.

[6]LIU YK, HU BS, LI ZL, et al.An improved strategty to detect the epithelial-mesenchymao transition process in circulating tumor cells in hepatocellular carcinoma patients[J].Hepatol Int, 2016, 10 (4) :640-646.

[7]ZHANG C, CHEN CN, LIN YX, et al.Clinical effect of transcatheter arterial chemoembolization combined with tegafur, gimeracil, and oteracil potassium in treatment of advanced hepatocellular carcinoma[J].J Clin Hepatol, 2014, 30 (1) :55-57. (in Chinese) 张呈, 陈昌南, 林云笑, 等.替吉奥联合经肝动脉化疗栓塞治疗中晚期肝细胞癌的疗效观察[J].临床肝胆病杂志, 2014, 30 (1) :55-57.

[8]YU XH, LOU JB, YAN JX, et al.Clinical observation on treatment of primary hepatocarcinoma patients with continuous low-dose oral Tegafur, Gimeracil and Oteracil Potassium Capsules and small dose TACE[J].Chongqing Med, 2015, 44 (24) :3367-3369. (in Chinese) 余小红, 娄继滨, 晏继喜, 等.替吉奥持续低剂量口服联合小剂量TACE治疗原发性肝癌疗效观察[J].重庆医学, 2015, 44 (24) :3367-3369.

[9]IWAMOTO H, TORIMURA T, NAKAMURA T, et al.Metronomic S-1 chemotherapy and vandetanib:an efficacious and non-toxic treatment for hepatocellular carcinoma[J].Neoplasia, 2011, 13 (3) :187-197.

[10]GHIRINGHELLI F, MENARD C, PUIG PE, et al.Metronomic cyclophosphamide regimen selectively depletes CD4+CD25+regulatory T cells and restores T and NK effector functions in end stage cancer patients[J].Cancer Immunol Immunother, 2007, 56 (5) :641-648.

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