| Objective:To observe the efficacy and safety of argon-helium knife cryoablation combined with FOLFOX chemotherapy in the treatment of liver metastatic colorectal cancer.Methods:A total of 37 patients with liver metastases of colorectal cancer who were treated in the fifth affiliated hospital of Zhengzhou University from August 2014 to August 2017 were retrospectively collected.Patients were classified into the control group(15 cases of single systemic FOLFOX systemic chemotherapy)and the observation group(22 cases of cryoablation combined with FOLFOX systemic chemotherapy)according to different treatment methods.Three months after the treatment,abdominal enhanced CT was performed to evaluate the liver tumor metastases,and all patients were followed up to calculate the overall survival time.SPSS25.0 statistical software was used to treat the patient’s treatment efficiency,survival rate,and tumor marker levels,Liver function changes,changes in argon-helium knife and chemotherapy adverse reactions were statistically analyzed,P<0.05 was considered statistically significant.Results:1.Effective treatment:After three months of treatment,the effective rates of the observation group and the control group were 72.7%(16/22)and 33.3%(5/15),respectively.The observation group had a higher effective rate and both the difference was statistically significant(χ2=5.639,P<0.05).2.Tumor marker levels:The average value of carcinoembryonic antigen before treatment in the observation group and control group was(118.01 ± 19.53)U/ml,(105.69 ± 14.07)U/ml.The average value of carcinoembryonic antigen in observation group and control group after 3 months of treatment was(44.85 ± 28.08)U/ml,(65.09 ± 19.09)U/ml;the average value of carbohydrate antigen 199 before treatment in the observation group and control group was(153.2 9±68.13)U/ml,(140 ± 60.58)U/ml.The average value of carbohydrate antigen 199 in observation group and control group after 3 months of treatment was(70.32±42.56)U/ml,(93.82±45.38)U/ml.The changes of carcinoembryonic antigen and carbohydrate antigen 199 levels were statistically analyzed.The difference was statistically significant(P<0.05).3.Changes in liver function:Comparing the degree of liver damage before and after treatment in the two groups,there were changes in liver function in both groups after treatment.The preoperative serum ALT levels in the observation group were(34.13 ±16.34)U/L,and the postoperative serum ALT levels were(108.18±41.88)U/L;the preoperative serum AST levels in the observation group were(30.16 ±14.44)U/L and postoperative serum AST levels were(101.52±35.81)U/L,respectively.ALT and AST in the observation group showed transient increase after surgery,and the difference was statistically significant(P<0.05).The ALT and AST levels in the two groups were decreased after liver treatment.However,there was no statistical significance between the two groups in the later period(P>0.05).4.Adverse reactions:The adverse reactions of argon-helium cryoablation are mainly fever and low fever,pain and discomfort in the liver area,and transient ALT and AST indicators.Adverse reactions to chemotherapy are mainly bone marrow suppression and gastrointestinal reactions,which can be effectively relieved after symptomatic supportive treatment.None of the patients in the two groups experienced grade 3 or higher toxic reactions during the course of treatment,and all patients completed the treatment as planned.There was no significant difference in the incidence of adverse reactions between the two groups of patients(P>0.05).Observe the pain at the puncture point before and after the treatment.The painevaluation method is recorded by visual analogue scale(VAS).5.Survival rate:the 12-,18-,and 24-month survival rates of the observation group were 81.8%,63.6%,and 50.0%in turn,the 12-,18-,and 24-month survival rates of the control group were 53.3%,33.3%,and 20.0%,respectively.the survival rate of patients in the observation group was higher than that in the control group,and thedifference was statistically significant(χ2=4.494,P<0.05).Conclusion:Argon-helium knife cryoablation is an effective and safe minimally invasive method.Argon-helium knife combined with chemotherapy and single systemic chemotherapy can alleviate clinical symptoms,reduce tumor burden,and prolong patient survival period(total survival time),argon-helium cryoablation combined with FOLFOX systemic chemotherapy for colorectal cancer liver metastasis has obvious clinical benefits,which is more advantageous than systemic chemotherapy alone. |
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