新疆医科大学学报

目的探讨奥沙利铂、丝裂霉素和多柔比星联合放疗在乏血供型肝细胞癌患者中的治疗效果。方法选取2016年6月-2018年6月于沈阳市第二中医医院接受治疗的78例乏血供型肝癌患者为研究对象,对照组和观察组患者各39例。对照组静脉滴注奥沙利铂,每2周滴注1次,每次剂量为130 mg/m²;同时向患者静脉注射丝裂霉素,每2周注射1次,每次注射10 mg;每3周1次向患者注射多柔比星,每次剂量为1.2 mg/kg。在后续治疗中按照每月1次的频率给予患者碘化油乳化剂及明胶海绵粒,治疗3个月后对患者实施肝动脉化疗栓塞术。观察组患者的治疗方式是在对照组已有治疗的基础上,给予总剂量为50～60 Gy照射,共计26～30次的放疗治疗,放疗频率为每周5次。2组患者均治疗12周,记录治疗期间发生的不良反应及其发生率,以及1～3年的生存例数及其生存率,并观察近期疗效。结果对照组和观察组患者客观缓解率分别为48.71%和64.10%(P<0.05);2组患者均出现血小板减少、血红蛋白下降和肝功能损坏等不良反应,但观察组不良反应发生率明显高于对照组(P<0.05);观察组患者各个时间区间的生存率均明显高于对照组(P<0.05)。结论奥沙利铂、丝裂霉素和多柔比星联合放疗用于乏血供型肝细胞癌患者,可明显延长患者的生存时间,能够取得良好的疗效;但易引发其他毒副反应,安全性还有待提高。

Objective To investigate the therapeutic effect of oxaliplatin, mitomycin and doxorubicin combined with radiotherapy in the patients with hypovascular hepatocellular carcinoma. Methods 78 patients with hypovascular hepatocellular carcinoma treated in our hospital from June 2016 to June 2018 were selected as the study subjects. The patients were divided into two groups according to the method of random number table. 39 cases in the control group and 39 cases in the observation group. Patients in the control group were given intravenous drip once every two weeks at a dose of 130 mg/m². At the same time, patients were given intravenous injection of mitomycin once every two weeks, 10 mg each time. In addition, patients were given doxorubicin every three weeks at a dose of 1.2 mg/kg. Patients were given lipiodol emulsifier and gelatin sponge granules at a monthly rate during follow-up treatment, and hepatic arterial chemoembolization was performed three months later. Patients in the observation group were given radiation therapy with a total dose of 50-60 Gy and a total of 26-30 times on the basis of the existing treatment in the control group. The frequency of radiation therapy was five times a week. Patients in both groups were treated for 12 weeks, and adverse reactions and their incidence during the treatment, as well as the number of 1-3 years of survival and their survival rate were recorded to observe the short-term efficacy. Results In the short term effect, the objective remission rate of the control group was 48.71%, the objective remission rate of the observation group was 64.10%(P<0.05). In the incidence of adverse reactions in the two groups, the two groups had adverse reactions such as thrombocytopenia, hemoglobin and liver function damage, but the number of adverse reactions in the observation group was higher than that of the control group(P<0.05). The survival rate of the observation group was higher than that of the control group at all time intervals. The difference between the above data was statistically significant(P<0.05). Conclusion The combined radiotherapy and oxaliplatin, mitomycin and doxorubicin can effectively prolong the survival time of the patients with hepatocellular carcinoma, with high remission rate and good curative effect, but it can easily lead to other toxic and side effects, and the safety is still should be improved.