立体定向放疗联合TACE治疗结直肠癌肝转移患者的疗效及对omentin-1、Ang-2表达的影响

doi:10.3760/cma.j.issn.1673422X.2018.02.006

摘要/Abstract

摘要： 目的探讨立体定向放疗联合肝动脉化疗栓塞治疗（TACE）对结直肠癌肝转移患者的疗效及对网膜素1（omentin1）、血管生成素2（Ang2）表达的影响。方法选取2013年12月至2015年12月收入我院的90例结直肠癌肝转移患者为研究对象，采用随机数字表法将其分为观察组和对照组，各45例。对照组接受单纯TACE治疗，观察组在对照组的基础上联合立体定向放疗。比较两组患者的临床治疗效果、外周血omentin1及Ang2的表达情况、生命质量评分及不良反应。结果观察组客观缓解率为82.2%，明显高于对照组的60.0%，差异具有统计学意义（χ2=5.409，P=0.020）。治疗后观察组omentin1及Ang2表达水平显著低于对照组［（43.7±18.1）ng/ml∶（52.1±17.9）ng/ml，t=2.214，P=0.029；（2.0±0.2）g/L∶（2.3±0.3）g/L，t=6.028，P＜0.001］。观察组生命质量评分显著高于对照组［（87.6±11.2)∶(68.7±10.3）］，差异有统计学意义(t=8.332，P＜0.001)。观察组肝功能异常、恶心呕吐、皮肤损伤、发热不良反应发生率与对照组比较差异均无统计学意义（35.6%∶42.2%， χ2=0.421，P=0.517；44.4%∶37.8%， χ2=0.413，P=0.520；6.7%∶0， χ2=3.101，P=0.078；35.6%∶31.1%， χ2=0.202，P=0.655）。结论立体定向放疗联合TACE治疗结直肠癌肝转移癌患者安全有效，能够有效降低外周血omentin1及Ang2的表达，抑制肿瘤血管增生，提高患者的生命质量。

关键词: 结直肠肿瘤, 放射外科手术, 肝动脉化疗栓塞术, 血管生成素2, 脂肪因子网膜素-1

Abstract: ObjectiveTo explore the curative effect of stereotactic radiotherapy combined with transcatheter arterial chemoembolization (TACE) for patients with hepatic metastases of colorectal cancer and influence on the expressions of omentin1 and angiopoietin2 (Ang2). MethodsA total of 90 patients with hepatic metastases of colorectal cancer from December 2013 to December 2015 in our hospital were selected as the research objects. Patients were divided into observation group and control group according to random number table method with 45 cases respectively. Patients in control group were treated with TACE, and patients in observation group were treated with stereotactic radiotherapy combined with TACE. After treatment, the clinical efficacy, expression levels of plasma omentin1 and Ang2, score of quality of life and adverse reaction were compared in the two groups. ResultsThe objective response rate in observation group (82.2%) was significantly higher than that in control group (60.0%), and the difference was statistically significant (χ2=5.409, P=0.020). After treatment, the omentin1 and Ang2 expression levels in observation group were lower than those in control group ［(43.7±18.1) ng/ml vs. (52.1±17.9) ng/ml, t=2.214, P=0.029; (2.0±0.2) g/L vs. (2.3±0.3) g/L, t=6.028, P＜0.001］. The score of quality of life in observation group was significantly higher than that in control group ［(87.6±11.2) vs. (68.7±10.3)］, and the difference was statistically significant (t=8.332, P＜0.001). There were no differences on the adverse reaction rates such as abnormal liver function (35.6% vs. 42.2%, χ2=0.421, P=0.517), nausea and vomiting (44.4% vs. 37.8%, χ2=0.413, P=0.520), skin injury (6.7% vs. 0, χ2=3.101, P=0.078) and fever (35.6% vs. 31.1%, χ2=0.202, P=0.655) between the two groups. ConclusionThe implementation of stereotactic radiotherapy combined with TACE in the treatment of hepatic metastases of colorectal cancer is a safety and effective method. It can significantly reduce the expression levels of plasma omentin1 and Ang2, inhibit of tumor angiogenesis, and improve the quality of life of patients.

Key words: Colorectal neoplasms, Radiosurgery, Transcatheter arterial chemoembolization, Angiopoietin-2, Omentin-1

杜为光. 立体定向放疗联合TACE治疗结直肠癌肝转移患者的疗效及对omentin-1、Ang-2表达的影响[J]. 国际肿瘤学杂志, 2018, 45(2): 87-91.

DU Wei-Guang. Curative effect of stereotactic radiotherapy combined with TACE for patients with hepatic metastases of colorectal cancer and influence on the expressions of omentin-1 and Ang-2[J]. Journal of International Oncology, 2018, 45(2): 87-91.

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