【摘要】 目的探讨沙利度胺(TLD)与TACE术联合应用对减少原发性肝癌介入术后的复发转移和延长生存期的效果。方法对80例行TACE术治疗的原发性肝癌患者随机分治疗组和观察组各40例,治疗组在TACE术的基础上加口服TLD由100mg/d递增至200mg/d或300mg/d,至少连续服用1个月,最长口服8个月。对照组不用TLD。每次介入术前或结束疗程后第1个月及以后每3个月复查CT/MRI,对病灶复发转移情况进行评价,同时作生存分析。结果治疗组与对照组平均复发或转移时间分别为148d(95%可信区间82~260d)和81d(95%可信区间30~180d),两组差异有统计学意义(P<0.05)。中位生存期分别为19个月(95%可信区间11~26月)和12个月(95%可信区间10~16月),两组差异有统计学意义(P<0.05)。治疗组6个月、12个月、18个月、24个月生存率分别为:治疗组:92.5%(37/40)、77.5%(31/40)、55.0%(22/40)、40.0%(16/40);对照组:80.0%(32/40)、50.0%(20/40)、40.0%(16/40)、22.5%(9/40)。采用χ2检验结果,P值分别为:0.105、0.01、0.01、0.007。结论沙利度胺联合TACE术,能延长原发性肝癌患者介入术后复发转移发生时间,并能适当延长中位生存期。更多还原

【Abstract】 Objective To investigate the effect of combined use of thalidomide(TLD)and transcartheter aterial chemoebolization(TACE)on the inhibition of recurrent metasasis and elongation of survival of primary liver cancer patients after perational intervention.Methods There 80 primary liver cancer were divided into treatment group consisted of 40 cases and treated with TAEC plus oral administration of TLD with the dose of 100mg daily and increased to 200mg daily or 300 mg daily at least for a course of 30 days and the longest 80 days and control group consisted of 40 cases treated with the same therapy without TLD.Clinical The conditions of recurrence and metastasis of foci were exmamined before operation intervention,a month after treatment and then every three months after treatment with computerized tomography and magnetic resonance imaging.The survival rates of the patients in the two grops were also analyzed.Results The average recrudescnt and metastatic times in the treatment group and control group were 148 day(95% condidence interval :82-260 days)and 86 days(95% confidence interval:30-180 days)showing significant difference(P<0.05).The medial survival period of the in the treatment group was 19 months and 12 months,showing significant difference(P<0.05).The survival rates of 6 months,12 months,18 months and 24 months in treatment group were 92.5%(37/40),77.5%(31/40),55.0%(22/40)and 40.0%(16/40);while that of the control group were 80.0%(32/40),50.0%(20/40),40.0%(16/40)and 22.5%(9/40).Conclusion The time of recrudensecnt metastasis in the liver cancer patients treated with TLD and TACE after operational interention and the median survival period can also be elongated.更多还原