肝动脉栓塞化疗联合槐耳颗粒对不可切除结直肠癌肝转移预后的影响(1)
[摘要] 目的 探讨肝动脉栓塞化疗(transarterial chemoembolization， TACE)联合槐耳颗粒对不可切除结直肠癌肝转移患者长期生存的影响。方法 回顾性分析2010年6月～2014年6月间在我院就诊的75例结直肠癌肝转移患者的临床资料。其中联合组36例患者接受肝动脉栓塞化疗同时口服槐耳颗粒(20 g/次，3次/d)，并在肝动脉栓塞化疗结束后继续维持服用，对照组39例患者仅接受肝动脉栓塞治疗。观察两组患者并发症及长期生存情况。 结果 联合组3年无肝内复发生存率明显高于对照组(12/36 vs.10/39，χ2=4.4426，P=0.0351， HR=0.5748， 95%CI： 0.3325～0.9936)；联合组3年总存活率明显高于对照组(18/36 vs 13/39， χ2=4.5397，P=0.0331， HR=0.5343，95%CI：0.2944～0.9696)。结论 肝动脉栓塞化疗同时联合使用槐耳颗粒能明显减少肝内复发，从而改善不可切除结直肠癌肝转移患者的长期生存。
[关键词] 肝转移；经肝动脉化疗栓塞术；预后；总生存率；肝内复发
[中图分类号] R735.34 [文献标识码] A [文章编号] 1673-9701(2017)31-0021-04
[Abstract] Objective To investigate the effect of transarterial chemoembolization (TACE) combined with Huaier granules on long-term survival of patients with liver metastasis of non-resectable colorectal cancer. Methods The data of 75 patients with liver metastasis of colorectal cancer who were admitted to our hospital from June 2010 to June 2014 were retrospectively analyzed. Among them， 36 patients in the combined group were given TACE combined with oral administration of Huaier granules(20 g/time， 3 times/day)， and the patients were continuously administered after the end of TACE. In the control group， 39 patients were only given TACE. The complications and long-term survival of the two groups were observed. Results The 3-year liver recurrence-free survival rate in the combined group was significantly higher than that in the control group(12/36 vs. 10/39， χ2=4.4426， P=0.0351， HR=0.5748， 95%CI：0.3325-0.9936)； the 3-year total survival rate in the combined group was significantly higher than that in the control group (18/36 vs. 13/39， χ2=4.5397， P=0.0331， HR=0.5343， 95%CI：0.2944-0.9696). Conclusion Hepatic arterial chemoembolization combined with Huaier granules can significantly reduce intrahepatic recurrence， so as to improve the long-term survival of patients with liver metastasis of unresectable colorectal cancer.
[Key words] Liver metastasis； Transarterial chemoembolization (TACE)； Prognosis； Overall survival rate； Liver metastasis
結直肠癌已经成为全球面临的巨大健康问题，全世界每年约有120万新发结直肠癌患者，而每年死于结直肠癌的患者大约有60万[1]。结直肠癌最有效的治疗是手术切除，但是超过一半的患者在术后会出现肝转移[2]。目前针对结直肠癌肝转移治疗的金标准是手术切除，而对于转移灶不可切除的患者应采取一系列姑息治疗手段以延长无进展生存和总生存[3]。经肝动脉化疗栓塞术(transarterial chemoembolization，TACE)是当今被公认为针对不可切除的肝恶性肿瘤最有效的姑息疗法之一，不仅具有创伤小、适应证广的优点，而且已被证实能显著改善1年和2年存活率[4]。但是由于肝动脉栓塞化疗治疗造成局部肝组织缺血缺氧，而且化疗药物往往会对正常组织器官功能产生一定程度的损害，引起肝肾功能不全、骨髓抑制、免疫功能紊乱等常见毒副作用[5-7]。槐耳颗粒由我国民间重要的药用真菌制成，具有一定的抗肿瘤作用和免疫调节作用[8， 9]，本研究在肝动脉栓塞化疗基础上联合槐耳颗粒来观察其对不可切除肝转移患者长期生存的影响。现报道如下。, http://www.100md.com(陈建红 唐成武)
[关键词] 肝转移；经肝动脉化疗栓塞术；预后；总生存率；肝内复发
[中图分类号] R735.34 [文献标识码] A [文章编号] 1673-9701(2017)31-0021-04
[Abstract] Objective To investigate the effect of transarterial chemoembolization (TACE) combined with Huaier granules on long-term survival of patients with liver metastasis of non-resectable colorectal cancer. Methods The data of 75 patients with liver metastasis of colorectal cancer who were admitted to our hospital from June 2010 to June 2014 were retrospectively analyzed. Among them， 36 patients in the combined group were given TACE combined with oral administration of Huaier granules(20 g/time， 3 times/day)， and the patients were continuously administered after the end of TACE. In the control group， 39 patients were only given TACE. The complications and long-term survival of the two groups were observed. Results The 3-year liver recurrence-free survival rate in the combined group was significantly higher than that in the control group(12/36 vs. 10/39， χ2=4.4426， P=0.0351， HR=0.5748， 95%CI：0.3325-0.9936)； the 3-year total survival rate in the combined group was significantly higher than that in the control group (18/36 vs. 13/39， χ2=4.5397， P=0.0331， HR=0.5343， 95%CI：0.2944-0.9696). Conclusion Hepatic arterial chemoembolization combined with Huaier granules can significantly reduce intrahepatic recurrence， so as to improve the long-term survival of patients with liver metastasis of unresectable colorectal cancer.
[Key words] Liver metastasis； Transarterial chemoembolization (TACE)； Prognosis； Overall survival rate； Liver metastasis
結直肠癌已经成为全球面临的巨大健康问题，全世界每年约有120万新发结直肠癌患者，而每年死于结直肠癌的患者大约有60万[1]。结直肠癌最有效的治疗是手术切除，但是超过一半的患者在术后会出现肝转移[2]。目前针对结直肠癌肝转移治疗的金标准是手术切除，而对于转移灶不可切除的患者应采取一系列姑息治疗手段以延长无进展生存和总生存[3]。经肝动脉化疗栓塞术(transarterial chemoembolization，TACE)是当今被公认为针对不可切除的肝恶性肿瘤最有效的姑息疗法之一，不仅具有创伤小、适应证广的优点，而且已被证实能显著改善1年和2年存活率[4]。但是由于肝动脉栓塞化疗治疗造成局部肝组织缺血缺氧，而且化疗药物往往会对正常组织器官功能产生一定程度的损害，引起肝肾功能不全、骨髓抑制、免疫功能紊乱等常见毒副作用[5-7]。槐耳颗粒由我国民间重要的药用真菌制成，具有一定的抗肿瘤作用和免疫调节作用[8， 9]，本研究在肝动脉栓塞化疗基础上联合槐耳颗粒来观察其对不可切除肝转移患者长期生存的影响。现报道如下。, http://www.100md.com(陈建红 唐成武)