摘要
目的探讨白蛋白结合型紫杉醇（Nab-P）一线治疗晚期原发性肝癌的临床效果和安全性。方法回顾分析2014年5月-2015年12月解放军总医院肿瘤内一科收治的23例晚期原发性肝癌患者的临床资料。按治疗方案分为观察组与对照组,观察组12例患者接受Nab-P治疗（其中Nab-P联合替吉奥5例,Nab-P联合卡培他滨5例,Nab-P单药2例）;对照组11例患者接受吉西他滨联合奥沙利铂治疗。各方案治疗21 d为1个周期,每治疗2个周期评价一次治疗效果,每个周期均评价不良反应。计数资料组间比较采用χ2检验或Fisher＇s精确检验,采用Kaplan-Meier生存曲线评价无进展生存期,采用log-rank检验比较不同组别生存率。结果所有患者均可评价疗效和不良反应,观察组患者中部分缓解2例、疾病稳定7例、疾病进展3例;对照组患者中部分缓解2例、疾病稳定5例、疾病进展4例,2组疾病控制率比较,差异无统计学意义（75%vs 64%,χ2=0.350,P〉0.05）。2组中位无进展生存时间比较差异亦无统计学意义[5.1（2.7-6.7）个月vs 4.3（2.5-5.4）个月,χ2=0.647,P〉0.05]。副反应方面,2组患者均未出现严重不良反应,其中PLT毒性及AST升高发生率差异有统计学意义（χ2值分别为5.490、6.135,P值分别为0.036、0.027）。结论基于新型Nab-P的药物方案对晚期原发性肝癌显示出较为良好的疗效,且毒副作用可耐受,但研究样本量较少,还需进一步的临床大样本研究。
Objective To investigate the clinical effect and safety of albumin-bound paclitaxel（ Nab-P） as the first-line treatment for advanced primary liver cancer. Methods A retrospective analysis was performed for the clinical data of 23 patients with advanced primary liver cancer who were admitted to the Department of Medical Oncology in Chinese PLA General Hospital from May 2014 to December 2015.According to the treatment regimen,these patients were divided into observation group and control group. The 12 patients in the observation group were treated with Nab-P,among whom 5 were treated with Nab-P combined with tegafur,gimeracil and oteracil,5 were treated with Nab-P combined with capecitabine,and 2 were treated with Nab-P alone; the 11 patients in the control group were treated with gemcitabine combined with oxaliplatin. One cycle of the treatment was 21 days for each treatment regimen; therapeutic effect was evaluated every2 cycles,and adverse events were evaluated every cycle. The chi-square test or the Fisher＇s exact test was used for comparison of categorical data between groups,the Kaplan-Meier survival curves were used to analyze progression-free survival,and the log-rank test was used to compare survival rates between groups. Results All the patients were eligible for evaluation of clinical outcome and adverse events.In the observation group,2 patients achieved partial remission,7 had a stable disease,and 3 had a progressive disease; in the control group,2 achieved partial remission,5 had a stable disease,and 4 had a progressive disease. There was no significant difference in disease control rate between the two groups（ 75% vs 64%,χ2= 0. 350,P 0. 05）. There was also no significant difference in the median progression-free survival between the two groups [5. 1（ 2. 7-6. 7） months vs 4. 3（ 2. 5-5. 4） months,χ2= 0. 647,P 0. 05]. As for adverse events,no patient experienced serious adverse events,and there were significant differences in the incidence rates of platelet toxicity and increased aspartate aminotransferase between the two groups（ χ2= 5. 490 and 6. 135,P = 0. 036 and 0. 027）. Conclusion In the treatment of advanced primary liver cancer,the medication based on Nab-P shows a good clinical effect and tolerable toxic and side effects; however,due to the small sample size in this study,the clinical studies with a large sample size are needed.
出处
《临床肝胆病杂志》
CAS
2016年第10期1911-1915,共5页
Journal of Clinical Hepatology
关键词
肝肿瘤
白蛋白类
药物疗法
联合
liver neoplasms
albumins
drug therapy
combination
