索拉菲尼联合肝动脉栓塞化疗对晚期肝细胞癌患者的疗效  

Efficacy Analysis of Sorafenib Combined with Transcatheter Arterial Chemoembolization for Advanced Hepatocellular Carcinoma

作　　者：徐艳霞[1] 高炜[1] 刘洁[2] 赵园园[3] 

机构地区：[1]青岛市肿瘤医院内三科,山东青岛266042 [2]青岛市肿瘤医院查体中心,山东青岛266042 [3]青岛医学院附属医院肿瘤科,山东青岛266003

出　　处：《肿瘤药学》2015年第5期372-378,共7页Anti-Tumor Pharmacy

摘　　要：目的比较索拉菲尼联合肝动脉栓塞化疗(TACE)与肝动脉栓塞化疗单一疗法对晚期肝癌患者的疗效。方法回顾性分析在我院肿瘤科接受治疗的287例晚期肝细胞癌患者,其中211例(73.5%)接受TACE单一治疗(单一治疗组),76例(26.5%)接受索拉菲尼联合TACE治疗(联合治疗组)。为了实现选择性偏差最小化,联合治疗组76例患者与152例单一治疗组患者使用倾向评分匹配(1∶2比率),分析比较两组的总生存期(OS)、疾病进展时间(TTP)和相关不良反应。结果在倾向得分匹配队列中,联合治疗组的OS显著高于单一治疗组(7.5月vs.4.2月,P=0.008),联合治疗组的TTP显著长于单一治疗组(2.8月vs.1.7月,P=0.002)。亚组分析显示,联合治疗组门静脉入侵的疗效显著优于单一治疗组(P<0.05)。单变量和多变量分析表明,索拉菲尼联合治疗是OS和TTP良好的独立预测因素(HR分别为0.65和0.68,P<0.05)。结论索拉菲尼联合TACE治疗晚期肝细胞癌的疗效显著优于单一TACE治疗。Objective To compare the efficacy of transarterial chemoembolization （TACE） combined with sorafenib versus TACE mono-therapy for patients with advanced hepatocellular carcinoma （HCC）. Methods We selected 287 patients with advanced HCC who underwent TACE therapy in our hospital. TACE alone （monotherapy group） was administered to 211 patients （73.5%）, and the remaining 76 （26.5%） underwent TACE and sorafenib therapy （combined group）. To minimize selection bias, the 76 patients were matched with 152 patients who received TACE monotherapy using propensity-score matching at a ratio of 1︰2. The overall survival （OS）, time to progression （TTP） and treatment-related adverse events were observed and compared between related subgroups. Results In the propensity-score–matched co-hort,theOSofthecombinedgroupwassignificantlyhigherthanthatofthemonotherapygroup（7.5months vs.4.2months,P=0.008）.The TTPwassignificantlylongerinthecombinedgroup（2.8months vs.1.7months,P=0.002）.Subgroupanalysisshowedthatpatientswithad-vanced HCC without main portal vein invasion who were treated with combined therapy achieved significantly better effects than those who received monotherapy （P〈0.05）. Univariate and subsequent multivariate analyses revealed that the addition of sorafenib was an independent predictor of favorable OS and TTP （adjusted hazard ratios, 0.65 and 0.68, respectively;P〈0.05 for both）. Conclusion Sorafenib combined with TACE was more effective than TACE monotherapy in treating patients with advanced HCC.

关 键 词：索拉菲尼 肝细胞癌 肝动脉栓塞化疗 

分 类 号：R735.7[医药卫生—肿瘤]