Clinical Study Of Raltitrexed Or 5-fluorouracil Combine With Oxaliplatin And Pirarubicin In The Treatment Of Advanced Hepatocellular Carcinoma

Objective:Study the safety and efficacy of Raltitrexed or 5-Fluorouracil combine with Oxaliplatin and Pirarubicin in the Treatment of Advanced Hepatocellular Carcinoma,for clinicians provide reasonable reference solutions.Methods:In the Affiliated Hospital of Qingdao University from September of 2012 to September of 2014,Sixty-five case of Advanced Hepatocellular Carcinoma patients were included in this study,all patients were in accordance which primary liver cancer diagnosis and treatment standards,which were promulgated by the ministry of health of the Peope’s Republic of China in 2011( [ 2011] 121),and all patients were confirmed by pathologic examination,clinical symptoms, epigastric enhanced computed tomography(CT),abdominal,B ultrasound and the level of AFP.According to the hospital number, single or double,all patients were randomly divided into two groups: Raltitrexed group(group A,n=31),the average age 57.55±2.58(35-73); 5-Fluorouracil group(group B,n=34),the average age 57.09±2.28(37-79). Recorded all patients’ data for preoperative and 4 weeks after surgery: liver function,the level of AFP,adverse reactions and tumor size changes. compared and assessed the survival rate of 6、12、18 months and themedian survival situation. Results:(1)Review the epigastric enhanced computed tomography(CT) after 4 weeks to estimate the tumor size,the effective rate of Raltitrexed group is 71.0%,5-Fluorouracil group is67.6%,the difference of the two group has no statistical differences(P>0.05);(2)After 4 weeks,the level of AFP of the two groups were all markedly reduced,the rate of descent of group A is 41.9%,group B is 38.2%, the difference of the two groups have no statistical differences(P>0.05),the change of liver function of the two groups were not obvious;(3)Comparing the incidence of adverse reactions(fever,nausea,vomit, neurotoxicity) of two groups,the fever rate of group A is 64.5%, group B is 70.6%,(P>0.05);the rate of nausea and vomit of group A is 25.8%,group B is 58.8%,(P<0.05);the rate of neurotoxicity of group A is 9.7%,group B is 29.4%,(P<0.05);(4)the survival rate of 6、12、18 months:group A is 93.5%、80.6%、41.9%;group B is 94.1%、73.5%、44.1%,no significant difference could be seen between group A and B(P>0.05);the mean survival time of group A and B is 453.8(95%CI 412.2~495.4)and 443.7(95%CI 400.1~487.3),(P>0.05);the median survival situation of the two groups is 530 and 540,(P>0.05),no significant difference could be seen between group A and B.Conclusions: The efficacy of Raltitrexed or 5-Fluorouracil combine with Oxaliplatin and Pirarubicin in the Treatment of Advanced Hepatocellular Carcinoma has no statistical differences.The side effects of Raltitrexed groupwere lower than 5-Fluorouracil group,and the safety is higher than5-Fluorouracil group.