Analysis Of The Curative Effect And Prognostic Factors Of Raltitrexed Combined With Oxaliplatin In TACE Of The Unresectable Primary Liver Cancer

Analysis of the curative effect and prognostic factors of raltitrexed combined with oxaliplatin in TACE of the unresectable primary liver cancer.Purpose:This study observed and investigated the curative effect of raltitrexed combined with oxaliplatin in TACE of the unresectable primary liver cancer and analysis the factors that may influence the prognosis of TACE,to provide the basis for improving the therapeutic effect of TACE and evaluating the prognosis of patients.Methods:In the Hospital of su bei people from january of 2017 to december of 2019,114 case of the unresectable primary liver cancer patients were included in this study,all patients were in accordance witch Primary liver cancer diagnosis and treatment standards,which were promulgated in 2017,and all patients were confirmed by clinical symptoms,pathologic examination,epigastric enhanced computed tomograpy(CT),abdominal bultrasound and the level of AFP.According to the hospital number,single or double,all Patients were randomly divided into two groups:group A(Raltitrexed+Oxaliplatin);groupB(Pirarubicin+Oxaliplatin),They were treated with two or five cycles of TACE,Recorded all patients’data for the general situation;preoperative and after surgery:liver function,the level of AFP,adverse reactions and tumor size changes.compared and assessed the progression-free survival and the median survival situation.survival analysis to analyze Prognostic factors.we use Kaplan-Meier method to estimate survival rate,log-rank test to compare survival curves between groups,Cox regression model to analysis influence factors of survival rate.Statistical analysis was onducted with SPSS 19.0 software,Countdata using X2 test,measurement data using t test,with P<0.05 was considered statistically significant.Results:1.ComLparison of curative effect1.1.Comparison of short-term curative effect1.1.1 Chang of tumor size114 cases were successfully treated with at least two times TACE treatment,The curative effect was evaluated in the 4-6 weeks after two treatment,the disease control rate of A group was 87.93%.In B group,the disease control rate was 82.14%。the differences between the two groups were not statistically significant(P>0.05)1.1.2 Chang of AFPThe level of AFP of the two groups were all markedly reduced,the rate of descent of group A is 41.37%,the rate of descent of g group B is 33.93%,the differences between the two groups were not statistically significant(P>0.05)1.2.Comparison of long-term curative effectThe survival rate of 6、12、18、24 months:group A is 93.10%、86.21%、50%、22.41%;group B is 91.07%、71.43%、28.53%、19.64%,the survival rate ofl8 months between the two groups were statistically significant,(P<0.05);the progression-free survival situation of the two group is 12 months and 9 months,significant difference could be seen between group A and B(P<0.05);the median survival situation of the two group is 18 months and 16 months(P>0.05),no significant difference could be seen between group A and B。more,the median survival situation ofgroup A Patients compare group B who was female、Hepatitis B、Child-Pugh B 级、ECOG 2、multiple tumors、tumor size>8cm、portal vein thrombosis、TNM stagingⅢa、AFP>400ug/ml is longer.2.Comparison of adverse drug reaction2.1 Comparison of gastrointestinal reactionIn the study group,the rate of gastrointestinal reaction(nausea,ventosity)of A group is 13.79%,the rate of gastrointestinal reaction(nausea,ventosity)of B group is75%,the differences between the two groups were statistically significant(P<0.05)2.2 Comparison of bone marrow suppressionAccording to comparing the preoperative and postoperative blood results in the two groups,the level of WBC of the two groups were partly reduced,the rate of descent of group A is 13.79%,the rate of descent of g group B is 30.36%,the difference of the two groups have statistical differences(P<0.05)2.3 Comparison of inj ury of liver functionAccording to comparing the preoperative and postoperative liver function in the two groups,they confirmed preoperative ALT、AST of A group were higher than B group,but the differences were no statistically significant(P>0.05).postoperative ALT,AST of A group were lower than B group,the differences have statisticalty significant(P<0.05)3.Analysis of prognostic factors3.1.Single factor analysisThe result of Log-rank tests shows that factors may affect the Prognosis of Patients with liver cancer are:classification of liver function、ECOG score、number of the tumor、tumor size、portal vein thrombosis、TNM staging、change of AFP、times of TACE。3.2 Multivariate regression analysisThe result of Cox regression shows that factors affect the Prognosis of Patients are portal vein thrombosis、TNM staging、number of the tumor、tumor size、change of AFP、times of TACE。The survival rate of Patients who has portal vein thrombosis、TNMstaging higher、multiple tumors、larger of tumor size is lower,while who has change of AFP、mang times of TACE is higherConclusions:1.The efficacy of Raltitrexed with OxaliPlatin in the treatment of unresectable HepatocellularCarcinoma can prolong the progression-free survival situation,The adverse reactions of Raltitrexed group were lower than Pirarubicin group,and the safety is higher。2.The median survival situation ofgroup A Patients compare group B who was female、Hepatitis B、Child-Pugh B 级、ECOG 2、multiple tumors、tumor size>8cm、portal vein thrombosis、TNM stagingⅢa、AFP>400ug/ml were longer.3.That factors affect the Prognosis of Patients are:portal vein thrombosis、TNM staging、number of the tumor、tumor size、change of AFP、times of TACE.