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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
Clinical effect of S-1 in treatment of circulating tumor cell-positive patients after radical surgery for primary hepatic carcinoma
文章发布日期:2018年02月07日  来源:  作者:王春梅, 曾建挺, 罗鲜樟,等  点击次数:518次  下载次数:86次

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【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021 6),疾病进展时间治疗组与对照组比较差异有统计学意义[(11.8±2.4)个月 vs (10.8±2.3)个月,t=4.31,P<0.05)]。观察期内2组患者均未出现死亡病例。治疗组5例出现不良反应,其中消化道反应2例、肝功能损伤2例、骨髓抑制1例。经对症处理后均好转,且未影响治疗药物的使用,所有患者均未发生Ⅲ级及以上副作用。结论替吉奥可使PHC根治术后CTC阳性患者的无瘤生存期延长,并未增加毒副作用。
【Abstract】:ObjectiveTo 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). MethodsA 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. ResultsThere 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. ConclusionS-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.
【关键字】:肝肿瘤; 循环肿瘤细胞; 替吉奥; 治疗结果
【Key words】:liver neoplasms; circulating tumor cell; oteracil; treatment outcome
【引证本文】:WANG CM, ZENG JT, LUO XZ, et al. Clinical effect of S-1 in treatment of circulating tumor cell-positive patients after radical surgery for primary hepatic carcinoma [J]. J Clin Hepatol, 2018, 34(3): 513-516. (in Chinese)
王春梅, 曾建挺, 罗鲜樟, 等. 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[J]. 临床肝胆病杂志, 2018, 34(3): 513-516.

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