吉西他滨联合奥沙利铂治疗中晚期原发性肝癌的临床对照研究_临床医学论文.docVIP

吉西他滨联合奥沙利铂治疗中晚期原发性肝癌的临床对照研究_临床医学论文 吉西他滨联合奥沙利铂治疗中晚期原发性肝癌的临床对照研究_临床医学论文 作者：彭春雷*，徐爱兵，苏小琴 【摘要】 　　目的： 观察吉西他滨联合奥沙利铂治疗晚期原发性肝癌的有效性及安全性。方法：50例晚期原发性肝癌患者随机分为两组，观察组27例采用吉西他滨联合奥沙利铂组成的GEMOX方案进行治疗，对照组23例采用单药吉西他滨，分别以RECIST标准和NCICTC标准观察和评价其疗效和毒性。结果：观察组的疾病控制率为63.0％，而对照组的疾病控制率为39.1％，两组差异有统计学意义（0.05）。两组最常见的毒副反应为骨髓毒性，以中性粒细胞和血小板下降为主；其次为消化道反应，以恶心、呕吐多见；观察组的毒副反应较对照组无明显增加。结论：吉西他滨联合奥沙利铂组成的GEMOX方案静脉化疗对于原发性肝癌的疗效优于单药组，且安全性高，不良反应较轻，患者易耐受，值得进一步临床试用。 【关键词】 原发性肝癌 吉西他滨 奥沙利铂 联合化疗 　　[Abstract] Objective: To observe the efficiency and safety of gemcitabin combined with oxaliplatin in treating the patients with histologically confirmed recurrent, metastatic, or unresectable hepatocellular carcinoma. Methods: After signing informed consent, 50 patients were randomly divided into the treatment group and the control group. 27 patients of the treatment group with advanced hepatocellular carcinoma were treated with the combination of Gemcitabine and oxaliplatin (GEMOX regimen) .And the other 23 patients of the control group were treated with Gemcitabine only. The efficiency was evaluated according to RECIST criteria, and toxicities according to American National Cancer Institute common toxicity criteria(NCICTC), respectively. Results: The disease control rate of treatment group was 63.0％, while that of the control group was 39.1％. There was obvious difference between two groups（0.05）. The most frequent adverse reaction of both groups was marrow　suppression including decrease of neutrophil and platelet mainly. Then alimentary canal reaction followed and nausea and vomiting could be seen frequently. The toxic reactions in both groups were the same. Conclusion: GEMOX regimen (Gemcitabine combined with oxalipatin) is a feasible systemic chemotherapy regimen that primarily shows promising antitumor activity, safety and low toxicities for the patients with advanced hepatocellular carcinoma. 　　[Key Words] Hepatocellular carcinoma; Gemcitabine; Oxalipatin; Combined chemotherapy 　　原发性肝癌是我国常见恶性肿瘤之一，但由于该病起病隐匿、早期诊断率低。大多