Clinical effect of S-1 in treatment of circulating tumor cell-positive patients after radical surgery for primary hepatic carcinoma
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摘要:
目的探索替吉奥治疗原发性肝癌(PHC)根治术后循环肿瘤细胞(CTC)阳性患者的效果。方法收集2014年6月-2016年1月重庆市肿瘤医院收治的PHC术后CTC阳性的患者56例。随机分为治疗组和对照组,每组28例。观察治疗后2组患者CTC数目变化、毒副作用、无瘤存活时间。计量资料2组间比较采用t检验,计数资料2组间比较采用χ2检验或Fisher精确检验,采用Kaplan-Meier法绘制生存曲线,2组存活率比较采用Breslow检验。结果治疗开始后2组在各检测时间点CTC数目分别为:3个月(2.1±1.2 vs 3.8±1.2)、6个月(1.9±1.3 vs 4.0±1.4)、12个月(1.5±1.2 vs 4.5±1.5)、18个月(1.6±1.4 vs 5.5±0.9),差异均有统计学意义(t值分别为5.52、5.96、8.17、12.33、P值均<0.000 1)。治疗组在治疗后1个月CTC数目较治疗前明显降低(t=8.10,P<0.000 1)。对照组随着时间推移,CTC数目较前明显增多。治疗组无瘤存活时间较对照组明显延长(t=5.279,P=0...
Abstract:Objective To investigate the clinical effect of tegafur, gimeracil, and oteracil ( S-1) in the treatment of circulating tumor cell ( CTC) -positive patients after radical surgery for primary hepatic carcinoma ( PHC) . Methods A total of 56 CTC-positive patients after radical surgery for PHC who were admitted to Chongqing Cancer Hospital from June 2014 to January 2016 were enrolled and randomly divided into treatment group and control group, with 28 patients in each group. The two groups were observed in terms of the change in the number of CTCs after treatment, toxic and side effects, and disease-free survival time. The t-test was used for comparison of continuous data between groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups; the Kaplan-Meier method was used to plot survival curves and the Breslow test was used for comparison of survival rates between the two groups. Results There were significant differences in the number of CTCs between the two groups at 3 months ( 2. 1 ± 1. 2 vs 3. 8 ± 1. 2, t = 5. 52, P < 0. 000 1) , 6 months ( 1. 9 ± 1. 3 vs 4. 0 ± 1. 4, t = 5. 96, P < 0. 000 1) , 12 months ( 1. 5 ± 1. 2 vs 4. 5 ± 1. 5, t = 8. 17, P < 0. 000 1) , and 18 months ( 1. 6 ± 1. 4 vs 5. 5 ± 0. 9, t = 12. 33, P < 0. 000 1) after treatment. The treatment group had a significant reduction in the number of CTCs at one month after treatment ( t = 8. 10, P < 0. 000 1) . The control group had a significant increase in the number of CTCs over time. The treatment group had a significantly longer disease-free survival time than the control group ( t = 5. 279, P = 0. 021 6) , and there was a significant difference in the time to progression between the treatment group and the control group ( 11. 8 ± 2. 4 months vs 10. 8 ± 2. 3 months, t = 4. 31, P < 0. 05) . No patient died during the observation period. Five patients in the treatment group experienced adverse events, among whom 2 had gastrointestinal reaction, 2 had liver injury, and 1 had myelosuppression, and all of them were improved after symptomatic treatment, without any influence on the administration of therapeutic drugs. No patient experienced grade ≥III side effects. Conclusion S-1 can increase the disease-free survival time of CTC-positive patients after radical surgery for PHC and does not increase toxic and side effects.
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Key words:
- liver neoplasms /
- circulating tumor cell /
- oteracil /
- treatment outcome
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