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经动脉化疗栓塞联合基于奥沙利铂的持续肝动脉灌注化疗治疗结直肠癌肝转移的预后因素。

Prognostic factors for transarterial chemoembolization combined with sustained oxaliplatin-based hepatic arterial infusion chemotherapy of colorectal cancer liver metastasis.

作者信息

Zhang Hangyu, Guo Jianhai, Gao Song, Zhang Pengjun, Chen Hui, Wang Xiaodong, Li Xiaoting, Zhu Xu

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing),1Department of Interventional Therapy.

Department of Radiology, Peking University Cancer Hospital & Institute, Beijing 100142, China.

出版信息

Chin J Cancer Res. 2017 Feb;29(1):36-44. doi: 10.21147/j.issn.1000-9604.2017.01.05.

Abstract

OBJECTIVE

To investigate the prognostic factors in chemorefractory colorectal cancer liver metastasis (CRCLM) patients treated by transarterial chemoembolization (TACE) and sustained hepatic arterial infusion chemotherapy (HAIC).

METHODS

Between 2006 and 2015, 162 patients who underwent 763 TACE and HAIC in total were enrolled in this retrospective study, including 110 males and 52 females, with a median age of 60 (range, 26-83) years. Prognostic factors were assessed with Log-rank test, Cox univariate and multivariate analyses.

RESULTS

The median survival time (MST) and median progression-free survival (PFS) of the 162 patients from first TACE/HAIC were 15.6 months and 5.5 months respectively. Normal serum carbohydrate antigen 19-9 (CA19-9, <37 U/mL) (P<0.001) and carbohydrate antigen 72-4 (CA72-4, <6.7 U/mL) (P=0.026), combination with other local treatment (liver radiotherapy or liver radiofrequency ablation) (P=0.034) and response to TACE/HAIC (P<0.001) were significant factors related to survival after TACE/HAIC in univariate analysis. A multivariate analysis revealed that normal serum CA19-9 (P<0.001), response to TACE/HAIC (P<0.001) and combination with other local treatment (P=0.001) were independent factors among them.

CONCLUSIONS

Our findings indicate that serum CA19-9 <37 U/mL and response to TACE/HAIC are significant prognostic indicators for this combined treatment, and treated with other local treatment could reach a considerable survival benefit for CRCLM. This could be useful for making decisions regarding the treatment of CRCLM.

摘要

目的

探讨经动脉化疗栓塞术(TACE)和持续肝动脉灌注化疗(HAIC)治疗化疗难治性结直肠癌肝转移(CRCLM)患者的预后因素。

方法

2006年至2015年期间,本回顾性研究共纳入162例行TACE和HAIC治疗的患者,总计接受763次治疗,其中男性110例,女性52例,中位年龄60岁(范围26 - 83岁)。采用Log-rank检验、Cox单因素和多因素分析评估预后因素。

结果

162例患者自首次接受TACE/HAIC治疗后的中位生存时间(MST)和中位无进展生存期(PFS)分别为15.6个月和5.5个月。单因素分析显示,血清糖类抗原19-9(CA19-9,<37 U/mL)(P<0.001)、糖类抗原72-4(CA72-4,<6.7 U/mL)(P = 0.026)、联合其他局部治疗(肝脏放疗或肝脏射频消融)(P = 0.034)以及对TACE/HAIC的反应(P<0.001)是TACE/HAIC治疗后生存的显著相关因素。多因素分析显示,血清CA19-9正常(P<0.001)、对TACE/HAIC的反应(P<0.001)以及联合其他局部治疗(P = 0.001)是其中的独立因素。

结论

我们的研究结果表明,血清CA19-9<37 U/mL以及对TACE/HAIC的反应是这种联合治疗的重要预后指标,联合其他局部治疗可为CRCLM患者带来可观的生存获益。这对于CRCLM的治疗决策可能具有指导意义。

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