目的 探讨肠癌肝转移术后患者运用槐耳颗粒联合辅助化疗的临床疗效。 方法 回顾性分析2012年1月~2017年12月中山大学附属第六医院行根治性切除的结直肠癌肝转移患者128例。根据术后辅助治疗方案不同分为两组，槐耳颗粒联合辅助化疗共72例，为治疗组，单纯辅助化疗56例，为对照组。统计两组患者临床病理资料，包括性别、年龄、术前癌胚抗原（CEA）、术前病理类型及原发肿瘤分期、肝转移瘤大小及数目、化疗完成情况、复发后局部治疗等。随访至2019年11月，使用随访数据计算生存率，并作影响复发和总生存时间的单因素及多因素分析。 结果 实验组围手术期化疗完成率高于对照组，治疗组及对照组术后3、5年总生存率分别为83.5%、60.7%与65.3%、48.2%，差异有显著性（p=0.015）；两组术后3、5年无复发生存率分别为77.8%、53.5%与59.7%、35.7%，差异有显著性（p=0.003）。多因素分析提示术前CEA水平，淋巴结转移，肝转移瘤个数及完成围手术期化疗影响肠癌肝转移患者术后复发；而原发灶合并淋巴结转移，肝转移瘤个数，完成围手术期化疗及槐耳颗粒维持治疗影响患者总生存时间。 结论 结直肠癌肝转移根治术后复发与肿瘤负荷和化疗相关。肝转移瘤单个、无淋巴结转移、以及槐耳颗粒联合辅助化疗的病人可能获得长期生存。
Abstract
Objective To investigate the clinical effects of Huaier granule combined with postoperative chemotherapy on recurrence and survival after curative resection of colorectal liver metastasis (CLM). Methods One hundred and twenty-eight patients with CLM who underwent curative resection at the sixth affiliated hospital, Sun Yat-sen University from January 2012 to December 2017 were followed up and analyzed retrospectively. Patients were divided into two groups according to the postoperative adjuvant therapy schedule. An experimental group: Huaier granule combined with chemotherapy (72 cases); a control group: only chemotherapy (56 cases). The following variables of two groups were analyzed: gender, age, carcinoembryonic antigen (CEA) lever, tumor depth, N stage, size of liver metastases, number of liver metastasis, chemotherapy before operation. The patients were followed up to November 2019. The followed up data were used to calculate the survival rate, and analyze the univariate factor and multivariate factor which affecting recurrence and long-term survival. Results The perioperative chemotherapy completion rate of the experimental group was higher than that of the control group. The 3-year and 5-year overall survival rates of the experimental group and the control group were 83.5%, 60.7% and 65.3%, 48.2%, respectively, with a significant difference (p=0.015).The recurrence free survival rates of the two groups were 77.8%, 53.5%, 59.7% and 35.7%, respectively, with a significant difference (p=0.003). Univariate and multivariate analysis showed that CEA level, lymph node metastasis, number of liver metastases and chemotherapy with perioperative completion affecting the postoperative recurrence of patients with CLM, primary tumors with lymph node metastasis, the number of liver metastases and Huaier Granule therapy affecting the overall survival. Conclusions The recurrence and overall survival of CLM after radical resection depend on the tumor burden and chemotherapy. The patients with single liver metastasis, no-lymph node metastasis and Huaier Granule combined with adjuvant chemotherapy, may have long-term survival.
关键词
结直肠癌 /
肝转移瘤 /
槐耳颗粒
Key words
Colorectal cancer; /
/
Liver metastasis; /
/
Huaier Granule
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基金
广东省医学科学技术研究基金（A2018250）
京ICP备08002354号-3
