Liu Yupeng, Yan Jingchen, Wang Feng
Department of Emergency, The First People's Hospital of Qinhuangdao, The Affiliated Hospital of Hebei Medical University, Qinhuangdao, Hebei 066000, P.R. China.
Department of Intervention, Liaocheng Cancer Hospital, Liaocheng, Shandong 252000, P.R. China.
Oncol Lett. 2018 Nov;16(5):5733-5738. doi: 10.3892/ol.2018.9374. Epub 2018 Aug 30.
To investigate the effects of transcatheter arterial chemoembolization (TACE) combined with precise radiation therapy (RT) on p53 gene expression and prognosis of patients with hepatocellular carcinoma (HCC). A total of 80 patients with unresectable HCC treated in the First People's Hospital of Qinhuangdao from March 2009 to March 2015 were randomly divided into TACE group (n=40) and TACE + RT group (n=40). Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of p53 in both groups before and after treatment. The biochemical indexes of liver function [α-fetoprotein (AFP), alanine aminotransferase (ALT) and γ-glutamyl transferase (GGT)] were detected. Moreover, adverse reactions were compared between the two groups of patients, the short-term therapeutic effect was evaluated, and effects of two treatment methods on progression-free survival (PFS) and overall survival (OS) of patients were detected. There were no statistically significant differences in clinical data between the two groups of patients (P>0.05). The p53 protein levels were significantly downregulated in both treatment methods, and it was decreased more significantly in TACE + RT group than that in TACE group (P<0.05). Compared with those before treatment, AFP and GGT levels in both groups of patients after treatment were decreased, but the levels of ALT were increased (P<0.05), and TACE + RT group had a better curative effect than TACE group (P<0.05). Besides, the incidence rate of adverse reactions in TACE + RT group (37.5%) was obviously lower than that in TACE group (65%) (P<0.05). The number of patients with stable disease (SD) and progressive disease (PD) and disease control rate (DCR) in TACE + RT group were superior to those in TACE group (P<0.05). The 2-year survival rate and median PFS of patients in TACE + RT group were also significantly better than those in TACE group (P<0.05). In conclusion, TACE combined with RT has a better clinical effect than TACE alone in the treatment of HCC.
探讨经动脉化疗栓塞术（TACE）联合精确放射治疗（RT）对肝细胞癌（HCC）患者p53基因表达及预后的影响。选取2009年3月至2015年3月在秦皇岛市第一人民医院治疗的80例不可切除HCC患者，随机分为TACE组（n = 40）和TACE + RT组（n = 40）。采用酶联免疫吸附测定（ELISA）法检测两组治疗前后p53水平。检测肝功能生化指标[甲胎蛋白（AFP）、谷丙转氨酶（ALT）和γ-谷氨酰转移酶（GGT）]。此外，比较两组患者的不良反应，评估短期治疗效果，并检测两种治疗方法对患者无进展生存期（PFS）和总生存期（OS）的影响。两组患者临床资料比较差异无统计学意义（P > 0.05）。两种治疗方法均可使p53蛋白水平显著下调，且TACE + RT组下降更明显（P < 0.05）。与治疗前比较，两组患者治疗后AFP和GGT水平降低，但ALT水平升高（P < 0.05），且TACE + RT组疗效优于TACE组（P < 0.05）。此外，TACE + RT组不良反应发生率（37.5%）明显低于TACE组（65%）（P < 0.05）。TACE + RT组疾病稳定（SD）和疾病进展（PD）患者数量及疾病控制率（DCR）均优于TACE组（P < 0.05）。TACE + RT组患者2年生存率和中位PFS也明显优于TACE组（P < 0.05）。综上所述，TACE联合RT治疗HCC的临床效果优于单纯TACE。
