Clinical effect of precise sequential interventional therapy in patients with unresectable hepatic metastasis after surgery for colorectal cancer / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the clinical effect of precise sequential interventional therapy in patients with unresectable hepatic metastasis after surgery for colorectal cancer. MethodsThe clinical data of 63 patients with unresectable hepatic metastasis after surgery for colorectal cancer, who were admitted to Air Force General Hospital, PLA from January 2005 to September 2012, were collected. According to therapeutic methods, these patients were divided into precise sequential interventional therapy group (group A, 33 patients) and systemic chemotherapy group (group B, 30 patients). The patients in group A underwent transcatheter arterial chemoembolization and radiofrequency ablation, and those in group B underwent systemic chemotherapy. The percentages of peripheral blood CD3+, CD4+, and CD8+ T cells and CD4+/CD8+ ratio were measured before and after the initial treatment. The level of carcinoembryonic antigen (CEA) was measured and compared before the initial treatment and after the final treatment, and follow-up was conducted to observe tumor progression and survival. The t-test was applied for comparison of continuous data between groups; the chi-square test was applied for comparison of categorical data between groups; the Wilcoxon rank sum test was applied for comparison of clinical effect; the Log-Rank test was applied for comparison of survival rate. ResultsIn group A, the percentages of CD3+, CD4+, and CD8+ T cells and CD4+/CD8+ ratio changed significantly after the initial treatment (t=4.52, -3.27, 2.95, and 4.54, all P＜0.05); serum CEA level also changed significantly after treatment(3876±957) μg/ml vs (1053±862) μg/ml, t=213,P=003). The serum level of CEA after the final treatment showed a significant difference between group A and group B (10.53±8.62) ug/L vs (35.21±1022) μg/L; t=5.23, P＜0.01). Group A had a significantly higher objective response rate than group B (66.7% vs 43.3%; Z=-2.042, P=0041). Group A had a significantly longer survival time than group B, and group A had a significantly higher surrival rate than group B(455% vs 233%， χ2=397,P=0046). ConclusionIn patients with unresectable hepatic metastasis after surgery for colorectal cancer, precise sequential interventional therapy can improve their immune function, increase clinical outcome, and prolong survival time.