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目的探讨经肝动脉EAP栓塞化疗方案联合常规分割外放疗治疗胃癌肝转移的效果。方法抽取2012年10月—2014年11月开封市肿瘤医院接收的42例胃癌肝转移患者,根据入院顺序分为联合组和化疗组,各21例。化疗组仅采用经肝动脉EAP化疗方案行栓塞化疗,联合组在此基础上实施常规分割外放疗。对比两组患者近期疗效、血清免疫因子水平变化情况及不良反应发生率和1年后生存率。结果联合组总缓解率71.4%高于化疗组的38.1%,差异有统计学意义(P<0.05);治疗前两组INF-γ、TNF-α、IL-2水平相比无显著差异(P>0.05),经治疗,联合组各项指标水平均优于化疗组,差异有统计学意义(P<0.05);联合组不良反应总发生率19.05%(4/21)略低于对照组的23.81%(5/21),但差异无统计学意义(χ2=0.000,P>0.05);1年后联合组存活率47.62%(10/21)略高于化疗组的33.33%(7/21),但差异无统计学意义(χ2=0.889,P>0.05)。结论经肝动脉EAP栓塞化疗方案联合常规分割外放疗治疗胃癌肝转移患者可有效改善血清免疫因子水平,提高远近期疗效,且不会增加不良反应发生率。
Objective To investigate the effect of transcatheter arterial chemoembolization (EAP) and hepatic artery chemoembolization (EAP) on hepatic metastasis of gastric cancer. Methods Forty-two patients with liver metastases from gastric cancer who were admitted to Kaifeng Cancer Hospital from October 2012 to November 2014 were selected and divided into the combined group and the chemotherapy group according to the sequence of admission. The chemotherapy group was treated with chemoembolization through the hepatic artery EAP chemotherapy alone, and the combined group was treated with conventional external beam radiotherapy. The two groups of patients were compared for short-term efficacy, changes in serum immune factors and the incidence of adverse reactions and 1-year survival rate. Results The total remission rate in combined group was 71.4%, which was significantly higher than that in chemotherapy group (38.1%, P <0.05). There was no significant difference in the levels of INF-γ, TNF-α and IL- > 0.05). After treatment, the levels of all the indexes in the combined group were better than those in the chemotherapy group (P <0.05). The total incidence of adverse reactions in the combination group was slightly lower than that in the control group (19.05%, 4/21) 23.81% (5/21), but the difference was not statistically significant (χ2 = 0.000, P> 0.05). After 1 year, the survival rate of the combined group was slightly higher than that of the chemotherapy group (47.62%, 10/21) ), But the difference was not statistically significant (χ2 = 0.889, P> 0.05). Conclusion The EAP embolization chemotherapy combined with routine external beam radiotherapy for patients with liver metastasis of gastric cancer can effectively improve the level of serum immune factors and improve the long-term and short-term efficacy without increasing the incidence of adverse reactions.