标题：5-Fu联合DDP肝动脉介入治疗对原发性肝癌终末期患者肿瘤标志物及生存期的影响

      作者：卢建新，陈晓敏，陈作波    (汕尾市人民医院肿瘤内科，广东 汕尾 516600)

      卷次： 2018年29卷14期

      【摘要】 目的 探讨5-氟尿嘧啶(5-Fu)联合顺铂(DDP)肝动脉介入治疗对原发性肝癌(PLC)终末期患者肿瘤标志物及生存期的影响。方法 选取汕尾市人民医院肿瘤内科2013年9月至2015年9月收治的终末期PLC患者152例，按随机数表法分为对照组和观察组，每组76例。对照组予以肝动脉化疗栓塞(TACE)联合5-Fu、表柔比星(EPI)灌注方案治疗，观察组予以TACE联合5-Fu、DDP灌注方案治疗，两组均采用单次灌注治疗。比较两组患者的近期临床疗效、血清肿瘤标志物水平、生活质量改善情况、不良反应发生率及生存期。结果 观察组患者的治疗总有效率为63.15%，明显高于对照组的46.06%，差异有统计学意义(P<0.05)；治疗后，观察组与对照组患者的血清甲胎蛋白(AFP)、甲胎蛋白异质体-L3 (AFP-L3)、糖类抗原199 (CA199)、癌胚抗原(CEA)水平比较，观察组均低于对照组，差异有统计学意义(P<0.05)；观察组患者治疗后的生活质量稳定改善率为69.74%，明显高于对照组的53.95%，差异有统计学意义(P<0.05)；治疗中出现的不良反应为血小板减少、恶心呕吐、腹泻及肾功能损害，两组间不良反应发生率比较差异无统计学意义(P>0.05)；与对照组比较，观察组患者的总生存时间(OS)、中位生存期(MST)、无进展生存时间(PFS)及中位疾病进展时间(TTP)均较长，差异有统计学意义(P<0.05)。结论 5-Fu联合DDP肝动脉介入治疗终末期PLC患者的近期临床疗效较好，其能明显降低血清肿瘤标志物水平，改善生活质量，延长患者生存期，且安全性较好。
      【关键词】 5-氟尿嘧啶；顺铂；终末期原发性肝癌；肿瘤标志物；生存期
      【中图分类号】 R735.7 【文献标识码】 A 【文章编号】 1003—6350（2018）14—1954—04

Effect of 5-fluorouracil combined with DDP hepatic artery intervention on tumor markers and survival time inpatients with primary liver cancer of the end stage.
LU Jian-xin, CHEN Xiao-min, CHEN Zuo-bo. Department ofMedical Oncology, Shanwei People's Hospital, Shanwei 516600, Guangdong, CHINA
【Abstract】 Objective To investigate the effect of 5-fluorouracil (5-Fu) combined with cisplatin (DDP) hepat-ic artery intervention on tumor markers and survival time in patients with primary liver cancer (PLC) of the end stage.Methods A total of 152 patients with end stage PLC in Department of Oncology, Shanwei People's Hospital from Sep-tember 2013 to September 2015 were selected. They were divided into control and observation group according to ran-dom number table, with 76 cases in each group. The control group received transcatheter arterial chemoembolization(TACE) combined with 5-Fu and epirubicin (EPI) perfusion regimen, and the observation group received TACE com-bined with 5-Fu and DDP perfusion regimen. Both groups were treated for 1 time. The recent clinical efficacy, serum tu-mor markers levels, improvement in quality of life, incidence of adverse reactions and survival time were compared be-tween the two groups. Results The effective rate in the observation group was 63.15%, which was significantly higherthan 46.06% in the control group (P<0.05). After treatment, the levels of serum alpha fetoprotein (AFP), alpha fetopro-tein heterogeneity-L3 (AFP-L3), carbohydrate antigen 199 (CA199) and carcinoembryonic antigen (CEA) in the observa-tion group were significantly lower than those of the control group, and the differences were statistically significant (P<0.05). The improvement rate of quality of life in the observation group was 69.74%, which was significantly higher than53.95% in the control group (P<0.05). The adverse reactions were thrombocytopenia, nausea and vomiting, diarrhea andrenal function damage between the two groups. There was no significant difference in the incidence of adverse reactionsbetween the two groups (P>0.05). The total survival time (OS), median survival time (MST), progression free survivaltime (PFS) and median time to progression (TTP) in the observation group were significantly longer than that in controlgroup, with statistically significant difference (P<0.05). Conclusion 5-Fu combined with DDP hepatic artery interven-tional therapy in the treatment of patients with end stage PLC was effective, which can significantly reduce the levels ofserum tumor markers, improve the quality of life and prolong the survival time of patients with highe safety.
      【Key words】 5-fluorouracil (5-Fu); Cisplatin (DDP); End stage primary liver cancer (PLC); Tumor markers; Sur-vival time·论 著·doi:10.3969/j.issn.1003-6350.2018.14.009