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目的评价三氧化二砷(AS2O3)联合肝动脉化疗栓塞(TACE)治疗中晚期原发性肝癌的近远期疗效和不良反应。方法选择2009年11月至2012年12月确诊的中晚期原发性肝癌62例,其中以AS2O3联合TACE治疗的30例为AS2O3组,以单纯TACE治疗的32例为对照组,观察两组患者治疗后近远期疗效,甲胎蛋白(AFP)下降情况、生活质量变化、肝内外转移发生率和不良反应发生率。结果 AS2O3组客观有效率、获益率、中位进展时间、1年生存率、AFP下降率、生活质量改善率和肝内外转移发生率分别为20.0%、80.0%、6.2个月、52.0%、76.5%、50.0%和20.0%。对照组客观有效率、获益率、中位进展时间、1年生存率、AFP下降率、生活质量改善率和肝内外转移发生率分别为15.6%、71.8%、5.3个月、46.0%、66.7%、43.8%和37.5%。两组患者不良反应差异无统计学意义(P>0.05)。两组患者在客观有效率、获益率、TTP、1年生存率、AFP下降率、生活质量改善率方面差异有统计学意义(P<0.05)。AS2O3组患者肝内外转移发生率显著低于对照组,差异有统计学意义(P<0.05)。结论 AS2O3联合TACE治疗中晚期原发性肝癌与以单纯TACE治疗相比较,AS2O3联合TACE治疗中晚期原发性肝癌有较好的近远期疗效,不增加不良反应,而且可降低肝癌肝内外转移的发生率。
Objective To evaluate the short-term and long-term effects and adverse reactions of AS2O3 combined with transcatheter arterial chemoembolization (TACE) in the treatment of advanced primary liver cancer. Methods Sixty-two patients with advanced primary hepatocellular carcinoma diagnosed from November 2009 to December 2012 were selected. Among them, 30 patients treated with AS2O3 combined with TACE were treated with AS2O3 and 32 patients treated with TACE alone as the control group. Two groups of patients Short-term efficacy after treatment, AFP decreased, quality of life changes, the incidence of intrahepatic metastases and the incidence of adverse reactions. Results The objective efficiency, benefit rate, median progression time, 1 year survival rate, AFP decline rate, quality of life improvement rate and intrahepatic and extrahepatic metastasis rates in AS2O3 group were 20.0%, 80.0%, 6.2 months and 52.0% 76.5%, 50.0% and 20.0%. The objective efficiency, benefit rate, median progression time, 1-year survival rate, AFP rate of decline, quality of life improvement rate and intrahepatic and extrahepatic metastasis in the control group were 15.6%, 71.8%, 5.3 months, 46.0% and 66.7 %, 43.8% and 37.5%. Adverse reactions between the two groups showed no significant difference (P> 0.05). The two groups of patients in the objective efficiency, benefit rate, TTP, 1-year survival rate, AFP rate of decline, quality of life improvement rate difference was statistically significant (P <0.05). The incidence of extrahepatic metastasis in AS2O3 group was significantly lower than that in control group (P <0.05). Conclusion AS2O3 combined with TACE in the treatment of advanced primary hepatocellular carcinoma compared with simple TACE treatment, AS2O3 combined with TACE in the treatment of advanced primary hepatocellular carcinoma has better short-term and long-term effects, does not increase the adverse reaction, but also reduces the liver metastasis The incidence of.