索拉非尼联合肝动脉化疗栓塞术治疗中晚期肝细胞癌疗效观察  

Efficacy of transcatheter arterial chemoembolization combined with sorafenib in treatment of patients with advanced hepatocellular carcinoma

作　　者：周学士[1] 任雷[2] 彭蕾[2] 叶阳群 朱晓黎[2] 冯婷婷[2] 赵卫峰[2] 

机构地区：[1]江苏省无锡市第五人民医院肝科七病区,214000 [2]苏州大学附属第一医院感染病科 [3]无锡市惠山区长安街道卫生服务中心

出　　处：《实用肝脏病杂志》2015年第1期59-62,共4页Journal of Practical Hepatology

基　　金：江苏省自然科学基金资助项目(编号BK20130271)

摘　　要：目的观察经导管肝动脉化疗栓塞术(TACE)与靶向治疗药相结合治疗中晚期肝细胞癌的疗效和安全性。方法 2008年1月至2012年12月我院收治的中晚期肝细胞癌患者60例,均采用TACE治疗,其中37例术后口服索拉非尼(400 mg,2次/d),根据不良反应调整用量,定期复查腹部CT。根据m RECIST标准进行疗效评价,观察患者的肿瘤进展时间和总生存期,并记录索拉非尼不良反应和TACE前后的肝功能变化。结果 37例应用TACE联合索拉非尼治疗患者的中位生存期为(13±0.98)m,显著长于23例单纯TACE治疗组[(7.3±1.20)m,P=0.001],肿瘤进展时间为(7.5±1.21)m,显著长于单纯TACE治疗组[(5±0.62)m,P=0.001];在随访结束时,联合治疗组疾病控制率为48.6%,显著高于单纯TACE组的17.4%(P<0.01);多因素分析显示有无联合应用索拉非尼、有无门脉癌栓、是否抗病毒治疗是显著影响生存时间的风险因素;索拉非尼治疗主要的相关不良反应为手足皮肤反应。结论 TACE联合索拉非尼治疗可延长中晚期肝细胞癌患者的疾病进展时间及总生存期,安全性好。Objective To observe the efficacy and safety of transcatheter arterial chemoembolization （TACE） combined with targeted therapy for advanced hepatocellular carcinoma. Methods From Jan. 2008,to Dec. 2012,60 cases of advanced hepatocellular carcinoma received TACE,among them,37 cases were treated with so- rafenib after TACE,at a dose of 400 mg,twice a day （the dosage was adjusted according to the side effect）. Ab- dominal CT scans were regularly performed and treatment efficacy was evaluated according to the modified RE- CIST. The side effect of sorafenib was recorded, so was the liver function before and after TACE. Results In 37 patients received combined treatment （TACE plus sorafenib） and 23 patients received TACE alone,the median overall survival time were （13±0.98） months and （5±0.62） months,respectively （P=0.001）,the time to progression were （7.5±1.21） months and （5±0.62） months,respectively （P=0.001）,and at the end of followed-up,the disease control rate were 48.6% and 17.4% in the two groups,respectively （P〈0.01）;The multivariate analysis showed that the risk factors for death were without combination of sorafenib and antiviral therapy,and the presence of portal vein tumor thrombus. The main side effect of sorafenib was hand-foot skin reaction. Conclusion TACE combined with sorafenib has prolonged time to disease progression and overall survival time in patients with advanced hepa- tocellular carcinoma with relatively good safety.

关 键 词：肝细胞癌 肝动脉化疗栓塞术 索拉非尼 预后 

分 类 号：R735.7[医药卫生—肿瘤]