紫杉醇联合顺铂、氟尿嘧啶经留置肝动脉导管给药用于胃癌肝转移的临床观察
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篇名: 紫杉醇联合顺铂、氟尿嘧啶经留置肝动脉导管给药用于胃癌肝转移的临床观察
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摘要: 目的:观察紫杉醇联合顺铂、氟尿嘧啶经留置肝动脉导管给药用于胃癌肝转移的疗效和安全性。方法: 56例胃癌肝转移患者随机分为对照组(28例)和观察组(28例)。对照组患者给予紫杉醇注射液135 mg/m2,d1+顺铂注射液75 mg/m2,d1+氟尿嘧啶注射液750 mg/m2,d1-5,均经中心静脉泵给药。观察组患者给予紫杉醇注射液135 mg/m2,d1+顺铂注射液75 mg/m2,d1+氟尿嘧啶注射液750 mg/m2,d1-5,均经留置肝动脉导管给药。两组均以3~4周为1个周期,最多治疗8个周期。两组患者治疗期间均静脉滴注异甘草酸镁注射液200 mg/d保肝治疗。观察两组患者的临床疗效,治疗前后血清癌胚抗原(CEA)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平及不良反应发生情况。结果:观察组患者近期总有效率显著高于对照组,差异有统计学意义(P<0.01)。治疗前,两组患者CEA、ALT、AST水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者CEA、ALT、AST水平均显著高于同组治疗前,且观察组ALT、AST水平显著高于对照组,但观察组CEA水平显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者骨髓抑制、恶心呕吐、发热发生率均显著低于对照组,差异均有统计学意义(P<0.05)。结论:紫杉醇联合顺铂、氟尿嘧啶经留置肝动脉导管给药用于胃癌肝转移的疗效较好,但存在肝功能损伤的现象。
ABSTRACT: OBJECTIVE: To observe the efficacy and safety of paclitaxel combined with cisplatin and fluorouracil for gastric cancer with liver metastases via indwelling hepatic arterial catheter. METHODS: 56 gastric cancer patients with liver metastases were randomly divided into control group (28 cases) and observation group (28 cases). Control group received Paclitaxel injection 135 mg/m2,d1+Cisplatin injection 75 mg/m2,d1+Fluorouracil injection 750 mg/m2,d1-5,pumping administrated via central venous. Observation group received Paclitaxel injection 135 mg/m2,d1+Cisplatin injection 75 mg/m2,d1+Fluorouracil injection 750 mg/m2, d1-5,administrated via indwelling hepatic arterial catheter. 3-4 weeks were a course, it lasted 8 courses at most. Magnesium isoglycyrrhizinate injection 200 mg/d was intravenously infused for liver protection in 2 groups during treatment. Clinical efficacy, serum carcinoembryonic antigen (CEA), alanine aminotransferase (ALT), aspartate aminotransferase (AST) levels before and after treatment, and the incidence of adverse reactions in 2 groups observed. RESULTS: Short-term clinical efficacy in observation group was significantly higher than control group, with statistical significance (P<0.01). Before treatment, there were no significant differences in CEA, ALT and AST levels (P>0.05). After treatment, CEA, ALT and AST levels in 2 groups were significantly higher than before, ALT and AST levels in observation group were significantly higher than control group, while CEA level in observation group was lower than control group, with statistical significances (P<0.05). The incidences of bone marrow suppression, nausea, vomiting and fever in observation group were significantly lower than control group, with statistical significances (P<0.05). CONCLUSIONS: Paclitaxel combined with cisplatin and fluorouracil has good efficacy for gastric cancer with liver metastases via indwelling hepatic arterial catheter, while it exists liver dysfunction.
期刊: 2017年第28卷第6期
作者: 胡彦辉,崔庆丽,马东阳,王怀璋
AUTHORS: HU Yanhui,CUI Qingli,MA Dongyang,WANG Huaizhang
关键字: 紫杉醇;顺铂;氟尿嘧啶;留置肝动脉导管;胃癌肝转移;疗效;安全性; 肝功能
KEYWORDS: Paclitaxel; Cisplatin; Fluorouracil; Indwelling hepatic arterial catheter; Gastric cancer with liver metastases; Efficacy; Safety; Live function
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