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目的观察沙利度胺联合肝动脉栓塞化疗治疗中晚期原发性肝癌的疗效及不良反应。方法 60例确诊为中晚期原发性肝癌的患者,随机分为试验组30例行沙利度胺联合肝动脉栓塞化疗,对照组30例单纯行肝动脉栓塞化疗,检测术前及术后4周血管内皮生长因子(VEGF)、甲胎蛋白(AFP)水平。结果两组均无完全缓解病例,试验组部分缓解18例,有效率60.0%,对照组部分缓解17例,有效率56.7%(P>0.05);试验组无疾病进展期为(5.67±2.44)个月,对照组为(3.33±2.09)个月(P<0.05);试验组总生存期为(9.33±7.58)个月,对照组为(8.67±6.83)个月(P>0.05);试验组术后血清VEGF、AFP水平较对照组降低(P<0.05)。试验组嗜睡、疲劳、头昏、皮疹等症状较对照组高,两组不良反应均可耐受。结论沙利度胺联合肝动脉栓塞治疗中晚期原发性肝癌与单纯行肝动脉栓塞化疗相比,能延长无疾病进展期,但不能提高有效率和延长总生存期,不良反应均可耐受。
Objective To observe the efficacy and adverse reactions of thalidomide and hepatic arterial chemoembolization in the treatment of advanced primary liver cancer. Methods Sixty patients diagnosed with advanced primary liver cancer were randomly divided into test group of 30 patients treated with thalidomide combined with hepatic arterial chemoembolization and control group of 30 patients treated with hepatic arterial chemoembolization alone. Preoperative and postoperative 4 Week vascular endothelial growth factor (VEGF), alpha-fetoprotein (AFP) levels. Results There were no complete remission cases in both groups. Eighteen cases were relieved in the experimental group, the effective rate was 60.0%, and 17 cases were relieved in the control group, the effective rate was 56.7% (P> 0.05). The progression-free period in the experimental group was (5.67 ± 2.44) (9.33 ± 7.58) months in the control group and (8.67 ± 6.83) months in the control group (P> 0.05). The average survival time in the control group was (3.33 ± 2.09) months The levels of serum VEGF and AFP in the postoperative group were lower than those in the control group (P <0.05). Test group lethargy, fatigue, dizziness, rash and other symptoms than the control group, two groups of adverse reactions can be tolerated. Conclusions Thalidomide combined with transcatheter arterial chemoembolization in the treatment of advanced primary hepatocellular carcinoma can prolong the disease-free progression compared with simple hepatic arterial chemoembolization, but can not improve the efficiency and prolong the overall survival, and the adverse reactions can be tolerated .