微波消融、TACE与全身化疗治疗结直肠癌肝转移的疗效

doi:10.3969/j.issn.1671-7171.2017.07.004

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摘要【目的】探讨微波消融、介入栓塞化疗(TACE)序贯方案与全身化疗治疗结直肠癌肝转移的临床疗效。【方法】根据不同治疗方案将80例结直肠癌肝转移患者分为观察组(全身化疗+微波消融+TACE序贯治疗)与对照组(全身化疗),比较两组近期疗效,预后及治疗前后细胞免疫功能变化。【结果】观察组近期客观有效率为66.67%(28/42),高于对照组的42.10%(16/38),且差异有显著性(P＜0.05);观察组首次治疗后CD3⁺、CD4⁺阳性率、CD4⁺/CD8⁺比值均显著大于,CD8⁺显著小于同组治疗前、对照组治疗后(均P＜0.05);观察组中位存活时间26.00个月长于对照组的13.60个月(P＜0.05)。【结论】在全身化疗基础上,行微波消融+TACE治疗能显著提高结直肠癌肝转移患者的有效率,明显改善机体免疫功能,延长患者存活时间。

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关键词 ：导管消融术/方法, 微波/治疗应用, 化学栓塞, 治疗性, 肝肿瘤/药物疗法, 肝肿瘤/继发性, 结直肠肿瘤/病理学

Abstract：【Objective】To compare the prognosis of patients with liver metastases of colorectal cancer treated by microwave ablation, transhepatic arterial chemotherapy and embolization (TACE) and systemic chemotherapy. 【Methods】According to different treatment methods, 80 cases of patients with liver metastases of colorectal cancer were divided into the observation group (treated by microwave ablation+TACE sequential therapy) and the control group (treated by systemic chemotherapy). The short-term curative effect and prognosis (survival) were compared between the two groups, and the changes of cell immune function before and after treatment were determined and recorded. 【Results】The short-term objective response rate (ORR) of the observation group was 66.67% (28/42)while that of the control group was 42.10%(16/38), and the difference was significant (P＜0.05). After initial treatment, positive rate of CD3⁺, CD4⁺ and the ratio CD4⁺/CD8⁺ were significantly higher, and CD8⁺ was significantly lower in the observation group than those in the same group before treatment and those in the control group after treatment (P＜0.05). The median survival time of the observation group was 26.00 months while that of the control group was 13.60 months (P＜0.05). 【Conclusion】On the basis of systemic chemotherapy , microwave ablation + TACE can significantly improve the effective rate of treatment for patients with liver metastases of colorectal cancer, significantly improve the immune function and prolong the survival time of patients.

Key words： Catheter Ablation/MT Microwaves/TU Chemoembolization, Therapeutic Liver Neoplasms/DT Liver Neoplasms/SC Colorectal Neoplasms/PA

收稿日期: 2017-04-01

PACS:

R735.37

基金资助:国家卫生计生委医药卫生科技发展项目(项目编号:W2015XR16)

引用本文:

艾冬梅,乔秀真,俞宏伟,张卜瑗,杜海峰,杨晓慧. 微波消融、TACE与全身化疗治疗结直肠癌肝转移的疗效[J]. 医学临床研究, 2017, 34(7): 1258-1260.
AI Dong-mei, QIAO Xiu-zhen, YU Hong-wei,et al. Comparison of Prognosis of Patients with Liver Metastases of Colorectal Cancer Treated by Microwave Ablation, Transhepatic Arterial Chemotherapy and Embolization and Systemic Chemotherapy. JOURNAL OF CLINICAL RESEARCH, 2017, 34(7): 1258-1260.

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http://www.jcr.net.cn/CN/10.3969/j.issn.1671-7171.2017.07.004 或 http://www.jcr.net.cn/CN/Y2017/V34/I7/1258