| 薛致骞,陈新民.肝动脉灌注化疗联合XELOX方案在胃肠道恶性肿瘤肝转移病人中的效果观察[J].安徽医药,2019,23(2):337-339. |
| 肝动脉灌注化疗联合XELOX方案在胃肠道恶性肿瘤肝转移病人中的效果观察 |
| Effect of hepatic arterial infusion chemotherapy combined with XELOX in patients with hepatic metastasis of gastrointestinal malignant tumors |
| 投稿时间：2017-03-23 |
| DOI： |
| 中文关键词: 胃肠道恶性肿瘤 肝转移 肝动脉灌注化疗 XELOX方案 |
| 英文关键词: Gastrointestinal malignant tumor Hepatic metastasis Hepatic arterial infusion chemotherapy XELOX regimen |
| 基金项目: |
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| 中文摘要: |
| 目的 研究并探讨肝动脉灌注化疗联合XELOX方案在胃肠道恶性肿瘤肝转移病人中的应用效果。方法 选取2012年6月至2014年1月经云南省第三人民医院治疗且随访3年成功的60例胃肠道恶性肿瘤肝转移病人作为研究对象,采取计算机单盲随机分组法将病人随机分为两组,对照组30例病人接受经全身静脉姑息性化疗,观察组30例病人接受经肝动脉灌注化疗联合XELOX方案治疗,比较两组近期疗效、中远期疗效、毒副反应发生率、肝功能指标以及生存质量评分。结果 近期疗效方面,观察组的近期总有效率70.00%高于对照组的43.33%(χ2=4.344,P=0.037)；中远期疗效方面,观察组的1年生存率(76.67%)高于对照组的50.00%(χ2=4.593,P=0.032),而其2年生存率、3年生存率与对照组的23.33%、16.67%比较差异无统计学意义(χ2=1.270、0.577,P=0.260、0.448)；治疗后,观察组的血清γ-谷氨酰转移酶(27.53±9.24)U/L、碱性磷酸酶(69.87±27.34)U/L均低于对照组的(41.76±14.37)、(113.45±48.63) U/L(t=4.562、4.279,均P=0.000)；毒副反应方面,观察组的恶心呕吐发生率(33.33%)、腹泻发生率(26.67%)、口腔炎发生率(30.00%)、脱发发生率(23.33%)均低于对照组的60.00%、53.33%、60.00%、56.67%(χ2=4.286、4.444、5.455、6.944,P=0.038、0.035、0.020、0.008)；生存质量方面,观察组的躯体健康评分(76.47±5.69)分、心理健康评分(79.14±6.43)分、社会功能评分(79.81±6.65)分、物质生活评分(84.52±7.67)分均高于对照组的(63.58±5.53)、(69.72±5.83)、(64.23±6.31)、(73.81±6.92)分(t=8.898、5.945、9.309、5.679,均P=0.000)。结论 在胃肠道恶性肿瘤肝转移病人中应用经肝动脉灌注化疗联合XELOX方案,可有效提高病人的近期疗效,延缓其肿瘤进展,尽可能提高病人的存活率,有效改善病人存活期内的生存质量,还可有效减少毒副反应,其对病人肝功能指标的不良影响相对较轻。 |
| 英文摘要: |
| Objective To study and explore the application of the hepatic artery infusion chemotherapy combined with XELOX regimen in patients with hepatic metastasis of gastrointestinal malignant tumors.Methods Sixty cases of patients with hepatic metastasis of gastrointestinal malignant tumors,who were treated in The Third People's Hospital from June 2012 to January 2014 and had been followed up for 3 years,were selected for the study.The patients were randomly assigned into two groups by computers with single-blind method:the control group (30 cases) received systematic venous palliative chemotherapy,while the observation group (30 cases) received hepatic arterial infusion chemotherapy combined XELOX scheme.A comparison was made between the groups of short-term efficacy,medium-long-term efficacy,adverse reactions,liver function index and quality of life.Results In terms of short-term efficacy,the overall short-term effective rate in the observation group was 70.00%,higher than 43.33% of the control group (χ2=4.344,P=0.037).In terms of medium-long-term efficacy,1-year survival rate (76.67%) in the observation group was higher than 50.00% in the control group (χ2=4.593,P=0.032),and 2-year survival rate and 3-year survival rate had no statistically significant difference from 23.33% and 16.67% in the control group (χ2=1.270,0.577,P=0.260,0.448).After treatment,Gamma-glutamyl transferase [(27.53±9.24) U/L] and alkaline phosphatase [(69.87±27.34) U/L] in the observation group were lower than those in the control group [(41.76±14.37) U/L,(113.45±48.63) U/L,respectively] (t=4.562,4.279,all P=0.000).In terms of adverse reactions,the incidences of nausea and vomiting (33.33%),diarrhea (26.67%),stomatitis (30.00%),and hair loss (23.33%) in the observation group were lower than those in the control group (60.00%,53.33%,60.00%,and 56.67%,respectively) (χ2=4.286,4.444,5.455,6.944,P=0.038\,0.035、0.020、0.008).In terms of quality of life,the physical health score (76.47±5.69) points,mental health score (79.14±6.43) points,social function score (79.81±6.65 points),material life score (84.52±7.67) points of the observation group were all higher than those of the control group [(63.58±5.53) points,(69.72±5.83) points,(64.23±6.31) points,(73.81±6.92) points,respectively] (t=8.898,5.945,9.309,5.679,all P=0.000).Conclusions Hepatic arterial infusion chemotherapy combined with XELOX regimen in patients with hepatic metastasis of gastrointestinal malignant tumors can effectively improve the short-term curative effect,delay tumor progression and improve the survival rate of patients as much as possible.It can effectively improve the quality of life and reduce the side effects of the patients,and the adverse effects on the liver function index are relatively slight. |
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