奥曲肽联合经动脉插管化疗栓塞治疗伴肝硬化肝细胞癌

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1、奥曲肽联合经动脉插管化疗栓塞治疗伴肝硬化肝细胞癌【摘要】　　目的评价奥曲肽联合经动脉插管化疗栓塞（TACE）治疗伴肝硬化肝细胞癌的临床效果。方法选择Child-Pugh评分A或B级伴肝硬化肝细胞癌患者共55例。实验组24例，行TACE术后第1天开始使用奥曲肽0.2mg皮下注射，每天2次。对照组31例，接受TACE治疗。每3个月进行1次评价。对两组6个月及1、2、3年的生存率进行比较。结果两组均无CR，实验组中16例PR，有效率为66.67%。对照组中11例PR，有效率为35.48%。两组有效率差异有显

2、著性(P<0.05)。实验组3年生存率为45.83%，而对照组3年生存率为19.35%。两组3年生存率差异有显著性（P<0.05）。实验组中位生存期为31个月，对照组中位生存期为20个月。实验组中位TTP为9个月，对照组为6个月。奥曲肽副作用主要为轻度腹泻。结论奥曲肽联合TACE治疗伴肝硬化肝细胞癌有明确的效果。【关键词】奥曲肽；肝硬化；肝细胞癌；化学栓塞，治疗性Abstract:ObjectiveThisarticleistoevaluatetheeffectsofoctreotidei

3、ncombinationwithtranscatheterarterialchemoembolization(TACE)forhepatocellularcarcinomacomplicatedwithlivercirrhosis.MethodsFifty-fiveconsecutivepatientsinChild-PughclassificationAandBwere12admittedintothe3-yeartrial.Twenty-fourpatientsintheoctreotidegro

4、upreceivedoctreotide0.2mgIHtwiceadayfollowingthetreatmentofTACEonday1.Thirty-onepatientsreceivedTACEalonewereenrolledintothecontrolgroup.Theefficacywereassessedonceevery3months.Acomparisonofthe6-month、1-year、2-yearand3-yearsurvivalratebetweenthetwogroup

5、swereperformed.ResultsNocompleteresponsewasgotinbothgroups.Intheoctreotidegroup,partialresponse(PR)wasgotin16(66.67%)ofthe24patients,whereasinthecontrolgroup,PRwasachievedin11(35.48%)ofthe31patients.Therewasstatisticalsignificantdifferenceinresponserate

6、betweenthetwogroups(P<0.05).The3-yearoverallsurvivalrateoftheoctreotidegroupandthecontrolgroupwere45.83%and19.35%,respectively.Therewasstatisticalsignificantdifferencein3-yearoverallsurvivalratebetweenthetwogroups(P<0.05).Theoverallsurvivalrateoft

7、heoctreotidegroupwassignificantlyhigherthanthatofthecontrolgroup(p<0.05).Themediansurvivaloftheoctreotidegroupandthecontrolgroupwere31monthsand20months,respectively.Thealimentdevelopmentintheoctreotidegroupwas9monthsvs6monthsinthecontrolgroup.Themajo

8、rcomplicationoftheoctreotidetreatmentwasmilddiarrhea.ConclusionItwaseffectiveof12octreotideincombinationwithTACEforhepatocellularcarcinomaassociatedwithlivercirrhosis.　　Keywords:Octreotide;livercirrhosis;hepatocellularcarcinoma;c