经肝动脉栓塞化疗治疗结肠癌肝转移患者临床初步研究

摘要

Objective To explore the clinical efficacy of transcatheter hepatic arterial embolization(TACE) in treatment of patients with liver metastasis from colon-rectal cancer. Methods 90 patients with liver metastasis from colon-rectal cancer in our hospital between November 2013 and November 2014 were recruited,and they were randomly divided into observation group and control group. The patients in both groups were treated with TACE,and the only difference was arterial infusion of raltitrexed in the observation group. Clinical efficacy,serum CA19-9 and CEA levels,adverse events and long-term survival rates were observed and recorded in the two groups. Results The total effective rate in the observation group was 51.1%,significantly higher than 22.2% in the control group(P<0.05);before treatment,there were no significant differences as respect to serum CA19-9 and CEA levels between the two groups(P>0.05),while three months after treatment,serum CA19-9 and CEA levels in the observation group were(18.46±7.59)U/ml and(3.52±2.58)ng/ml,significantly lower than [(27.65±11.85) U/ml and(9.86 ±3.47)ng/ml,respectively,in the control group,P<0.05];the incidence of adverse reactions was 22.2% in the observation group,significantly lower than 46.7% in the control group(P<0.05);the 1 a,2 a and 3 a survival rates in the observation group was 88.9%,73.3% and 57.8%,respectively,obviously higher than 66.7%, 42.2% and 33.3% in the control group(P<0.05). Conclusion The application of raltitrexed in TACE treatment of patients with liver metastasis from colon-rectal cancer can effectively improve patients' clinical efficacy,prolong the long-term survivals.%目的 探讨肝动脉栓塞化疗(TACE)治疗结肠癌肝转移患者的临床效果.方法 2013年11月~2014年11月于中国石油天然气集团公司中心医院诊治的结肠癌肝转移患者90例,被随机等分为观察组45例和对照组45例.两组均接受TACE治疗,只是观察组在治疗过程中应用雷替曲塞灌注.常规检测血清CA19-9和CEA水平.结果 观察组近期临床治疗总有效率为51.1%,显著高于对照组的22.2%(P<0.05);两组患者治疗前血清CA19-9和CEA水平比较差异无统计学意义(P>0.05),治疗后3月两组上述肿瘤指标均有明显降低,观察组血清CA19-9和CEA水平分别为(18.46±7.59)U/ml和(3.52±2.58)ng/ml,明显低于对照组的[(27.65±11.85)U/ml和(9.86±3.47)ng/ml,P<0.05];观察组不良反应发生率为22.2%,显著低于对照组的46.7%(P<0.05);观察组1a、2a、3a生存率分别为88.9%、73.3%、57.8%,明显高于对照组的66.7%、42.2%、33.3%(P<0.05).结论 TACE术中应用雷替曲塞灌注治疗结肠癌肝转移患者可有效提高近期和远期临床治疗效果,在临床治疗上具有一定的参考意义.