肝动脉栓塞化疗术联合索拉菲尼对比单纯介入术治疗原发性肝癌的临床观察  

The clinical observation of transcatheter arterial chemo-embolization(TACE) combined with sorafenib compare with TACE alone in the treatment of primary hepatocellular carcinoma

作　　者：吴金道[1] 韩国勇[1] 陆森[1] 邵文雨[1] 杨正强[2] 刘圣[2] 黄新立[1] 

机构地区：[1]南京医科大学第一附属医院肝脏外科,江苏南京210029 [2]南京医科大学第一附属医院介入放射科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2015年第12期1739-1742,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省六大人才高峰基金项目(2014-WSW-005)

摘　　要：目的 :评价肝动脉化疗栓塞术(TACE)联合索拉菲尼治疗中晚期原发性肝癌的临床疗效。方法 :将115例中晚期原发性肝癌患者(均为TNM分期)随机分为治疗组和对照组,治疗组58例,给予TACE术+索拉菲尼治疗,对照组57例,行TACE术治疗。观察两组患者的近期疗效、远期生存率及不良反应。结果:治疗结束后2个月治疗组的疾病控制率为74.1%,对照组为64.9%,两组比较无显著统计学差异(P=0.282)。治疗组的中位生存期为13.2个月,对照组的中位生存期为9.6个月,两组比较有显著统计学差异(P<0.001)。治疗组和对照组的1年生存率分别为62.5%和32.1%,两组比较有显著统计学差异(P=0.001)。两组的不良反应主要表现为胃肠道反应、骨髓抑制、皮肤黏膜反应及肝功能异常等。其中治疗组口腔黏膜炎及手足皮肤反应的发生率明显高于对照组,两组比较有显著统计学差异(P均<0.001,P<0.001)。结论:TACE联合索拉菲尼可提高中晚期原发性肝癌患者的1年生存率,且不良反应较小。Objective：To evaluate the clinical efficacy of transcatheter arterial chemo-embolization（TACE）combined with sorafenib on the treatment of primary advanced hepatocellular carcinoma. Methods：Totally 115 patients with primary hepatocellular carcinoma（TNM stage）were randomly divided into two groups：58 cases in treatment group received TACE ＋ sorafenib treatment;57 cases in control group received TACE therapy. The short-term effect,long-term survival,and adverse reactions were analyzed between two groups. Results：Two months after treatment,the disease control rate in the treatment group and the control group was 74.1 % vs64.9%,there was no statistically significant difference betweer two groups（P = 0.282）. The median survival time in the treatment group was 13.2 months,and that of the control group was 9.6 months,and there was a significant difference between two groups（P〈0.001）. One-year survival rate of the treatment group and the control group was 62.5 % and 32.1 %,respectively,and there was a significant difference between two groups（P = 0.001）. Adverse events in two groups were mainly gastrointestinal reactions,bone marrow suppression,mucocutaneous reactions and liver abnormalities. The incidence of oral mucositis and hand-foot skin reaction in the treatment group was significantly higher than that of control group,and there were significant difference between two groups（P〈0.001,P〈0.001）. Conclusion：TACE combined with sorafenib in patients with advanced hepatocellular carcinoma can improve patients＇ 1-year survival rate with the mild side effects.

关 键 词：肝动脉栓塞化疗 索拉菲尼 肝肿瘤 

分 类 号：R735.7[医药卫生—肿瘤]