索拉非尼应用于肝癌TACE术后的效果及意义  

Effect of sorafenib combined with transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma

作　　者：杨立学[1] 薛峰[1] 孙延富[1] 王义[1] 施纯朝[1] 

机构地区：[1]第二军医大学附属上海东方肝胆外科医院,上海200438

出　　处：《实用药物与临床》2013年第9期783-786,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨索拉非尼与经皮肝动脉化疗栓塞术(TACE)联合治疗肝癌的效果及预后。方法选择我院首次接受肝癌治疗的患者90例,随机分为2组,观察组接受TACE治疗后第4天服用索拉非尼,每次400 mg;对照组仅接受TACE治疗。2个疗程后比较两组患者治疗的有效率及疾病控制率,血清甲胎蛋白浓度、血管内皮生长因子浓度,生活质量及不良反应率。结果观察组治疗有效率为35.6%,疾病控制率为73.3%,均高于对照组的20.0%及53.3%,差异有统计学意义(P<0.05);观察组48.9%的患者甲胎蛋白浓度下降超过50%,而对照组为24.4%,两组比较差异有统计学意义(P<0.05);观察组患者术后VEGF浓度明显下降(P<0.01),而对照组呈上升趋势,但对照组治疗前后比较差异无统计学意义(P>0.05);观察组患者的ECOG评分显著高于对照组(P<0.05),观察组的腹泻、手足综合征、高血压和皮疹发生率显著高于对照组(P<0.05),但治疗后均得到缓解。结论索拉非尼联合TACE术是一种有效的肝癌治疗方法 ,降低了VEGF的浓度,从而可能降低肿瘤的复发率,且其引起的不良反应可以通过治疗得到缓解,值得临床推广使用。Objective To evaluate the effect of sorafenib combined with transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma.Methods 90 patients who accepted the treatment of liver cancer for the first time were divided into two groups.The observation group was treated with TACE,on the fourth day,it was given sorafenib,400 mg each time.The control group only received TACE treatment.The efficiency and disease control rate,serum alpha-fetoprotein levels,vascular endothelial growth factor concentration,quality of life and adverse reactions rate of the two groups were compared after two courses of treatment.Results The effective rate and disease control rate of observation group（35.6% and 73.3%） were higher than those of the control group（20.0% and 53.3%,P0.05）; 48.9% and 24.4% of patients＇ alpha-fetoprotein concentration in observation group and control group decreased more than 50%,there was significant differenec between the two groups（P0.05）; The concentration of VEGF in observation group declined（P0.01）,while the control group had upward without significant difference（P 0.05）; The ECOG score in observation group was significantly higher than that of control group（P 0.05）,the rates of diarrhea,hand-foot syndrome,hypertension and rash in observation group were significantly higher（P0.05）,but alleviated after treatment.Conclusion Sorafenib combined with TACE is an effective treatment for hepatocellular carcinoma,it can reduce the concentration of VEGF,which may reduce the rate of recurrence of the tumor and the adverse reactions can be alleviated through treatment,it is worthy of clinical use.

关 键 词：肝癌 索拉非尼 化疗栓塞 血管内皮生长因子 

分 类 号：R735.7[医药卫生—肿瘤]