摘要
目的 观察CalliSpheres载药微球肝动脉化疗栓塞(DEB-TACE)序贯冷循环微波消融(MWA)对单发直径5~10 cm老年原发性肝癌(PHC)的近远期疗效以及安全性。方法 回顾性收集2016-08-01-2017-06-30就诊于聊城市肿瘤医院的64例老年PHC患者的临床资料。其中对照组32例患者行单纯DEB-TACE方案治疗,观察组32例患者行DEB-TACE序贯MWA方案治疗。比较2组患者治疗后1个月的疗效和CD4^(+)、CD8^(+)T淋巴细胞水平以及生存率和不良反应。结果 治疗后1个月观察组的客观缓解率(ORR,78.1%)和疾病控制率(DCR,96.9%)均高于对照组(50.0%和81.3%),差异有统计学意义,χ^(2)值分别为5.479和4.010,P值分别为0.019和0.045。观察组治疗1个月后CD4^(+)/CD8^(+)(1.70±0.18)高于对照组(1.08±0.21),差异有统计学意义,t=-7.98,P<0.001。观察组及对照组的中位无进展生存期(11.00±0.70和8.00±0.38)、中位总生存期(18.00±1.91和11.00±0.80)差异均有统计学意义,χ^(2)值分别为9.017和9.834,P值均为0.002。观察组1年PFS率(43.8%)、1年生存率(75.0%)和2年生存率(34.4%)均高于对照组(18.8%、31.3%和9.4%),χ^(2)值分别为4.655、12.298和5.851,P值分别为0.030、<0.001和0.016。2组骨髓抑制、消化道反应、肝肾功能损伤、发热等不良反应率差异无统计学意义,均P>0.05。结论 CalliSpheresDEB-TACE序贯MWA治疗可更有效地杀死肿瘤细胞,明显延长患者生存期,且并发症可控。
Objective To observe the short-and long-term efficacy and safety of CalliSpheres drug-loaded microspheres(DEB)transcatheter arterial chemoembolization(TACE)and sequentially combined with percutaneous cold-circulation microwave ablation(MWA)in the treatment of single primary hepatocellular carcinoma(PHC)of the elderly with a diameter of 5-10 cm.Methods The clinical data of 64 elderly patients with primary liver cancer(PHC)treated in Liaocheng Cancer Hospital from August 1,2016 to June 30,2017 were retrospectively analyzed.The 32 cases in the control group were treated with DEB-TACE,and 32 cases in the observation group were treated with DEB-TACE sequential MWA.We observed and compared the curative effects of the 2 groups 1 months post-treatment(according to the evaluation criteria of solid tumor curative effect),the levels of CD4^(+)and CD8^(+)T lymphocytes,survival rate and adverse effects.Results The objective response rate(ORR,78.1%vs 50.0%)and disease control rate(DCR,96.9%vs 81.3%)of the observation group after 1 month’s treatment were higher than those of the control group,and the difference was statistically significant(χ^(2)=5.479,P=0.019;χ^(2)=4.010,P=0.045);One month after treatment,CD4^(+)/CD8^(+)of the observation group was significantly higher than those of the control group(1.08±0.21 vs 1.70±0.18),and the difference was statistically significant(t=-7.98,P<0.001);There were statistically significant differences on PFS(11.00±0.70 vs 8.00±0.38)and OS(18.00±1.91 vs 11.00±0.80)survival curves between two groups(χ^(2)=9.017,P=0.002;χ^(2)=9.834,P=0.002).The 1-year disease-free progression ratio in the observation group(43.8%vs 18.8%),the 1-year and 2-year survival rate(1year:75.0%vs 31.3%;2year:34.4%vs 9.4%)were all higher than those in the control group(χ^(2)values were4.655,12.298and 5.851;Pvalues were 0.030,<0.001and 0.016).There was no significant difference in the adverse reaction rates,including bone marrow suppression,gastrointestinal reactions,liver and kidney function damage,and fever between the two groups(P>0.05).Conclusion CalliSpheres DEB-TACE combining with MWA treatment can kill tumor cells more effectively,prolong the survival time,and have controllable complications.
作者
吕然
刘琛志
LYU Ran;LIU Chen-zhi(Department of Interventional Oncology,Liaocheng Tumor Hospital,Liaocheng 252000,China;Department of Interventional Oncology,Liaocheng People's Hospital,Liaocheng 252000,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2022年第15期1136-1142,共7页
Chinese Journal of Cancer Prevention and Treatment
基金
山东省医药卫生科技发展计划项目(202103100816)。
作者简介
第一作者:吕然,男,山东聊城人,副主任医师,主要从事肿瘤微创治疗方面的研究工作。E-mail:1325861949@qq.com;通信作者:刘琛志,男,山东聊城人,副主任医师,主要从事肿瘤介入治疗方面的研究工作。E-mail:m13863540856@126.com。
