索拉非尼联合替吉奥治疗晚期肝癌的临床观察  

Clinical study of Sorafenib combined with S-1 in advanced hepatocellular carcinoma

作　　者：李建旺[1] 黄春珍[1] 元建华[1] 陈琼慧 刘英平[1] 孟娟[1] 张曙波 Jian-wang Li Chun-zhen Huang Jian-hua Yuan Qiong-hui Cheng Ying-ping Liu Juan Meng Shu-bo Zhang(Department of Oncology, People＇s Hospital of Haikou, Haikou, Hainan 570208, Chin)

机构地区：[1]海南省海口市人民医院肿瘤科,海南海口570208

出　　处：《中国现代医学杂志》2016年第24期77-82,共6页China Journal of Modern Medicine

摘　　要：目的比较索拉非尼联合替吉奥与索拉非尼单药治疗肝功能Child—PughA级的晚期肝癌患者的疗效和安全性。方法回顾性分析经病理组织学检查确诊的肝细胞癌Ⅳ期患者56例，其中27例患者行索拉非尼联合替吉奥治疗，29例行索拉非尼单药治疗。收集所有患者的临床病理和人口学特征。使用Kaplan-Meier方法对无进展生存期（PFS）和总生存期（OS）进行生存分析。结果可评价患者56例，中位随访8个月（4～36个月），联合组和单药组分别接受2．9个周期（1～8个周期）和3．5个周期（1～6个周期）治疗（P=0．44）。联合组和单药组疾病控制率（DCR）分别为48．1％和37．9％（χ^2=0．650，P=0．171）。联合组与单药组中位PFS分别为5-2和3．4个月（χ^2=7．329，P=0．007），中位OS8．8和6．2个月（χ^2=3．095，P=0．08）。联合组3／4级毒性主要与化疗药物有关，天门冬氨酸氨基转移酶（AST）的增加（18．5％），血小板减少症（14．8％），中性粒细胞减少症（22．2％），手足综合征（22．2％）。单药组3／4级毒性表现为AST增加（3．5％），中性粒细胞减少症（6．8％），皮肤损害（3．4％）。结论索拉非尼联合替吉奥治疗晚期肝细胞癌与目前推荐的单药索拉非尼相比，有效率提高10．2％，PFS延长1．8个月，OS延长2．6个月，安全性良好，值得临床上推广应用和进一步观察。Objective To compare the efficacy and safety of sorafenib combined with S-1 and single-agent sorafenib treatment Child-Pugh A grade of liver function in patients with advanced hepatoeellular carcinoma. Methods A total of 56 patients were included to this study, 27 and 29 patients were treated with sorafenib combined with S-1 and single-agent sorafenib respectively. The elinieopathologieal and demographic characteristics of all patients were collected from the medical charts. Kaplan-Meier survival analysis was carried out for PFS and OS. Results The median follow-up of our study was 8 （4 - 36） months. In both groups, median cycle of 56 patients was 2.9 （1 - 8） and 3.5 （1 - 6） in sorafenib combined with S-1 and single-agent sorafenib groups, respectively （P = 0.44）. Overall response rate was observed in 48.1% and 37.9% of patients in sorafenib combined with S-1 and single-agent sorafenib groups, respectively （χ^2 = 0.650, P = 0.171）. Median PFS was 5.2 and 3.4 months in sorafenib combined with S-1 and single-agent sorafenib groups, respectively （χ^2 = 7.329, P = 0.007）. Median OS was 8.8 and 6.2 months in sorafenib combined with S-1 and sorafenib single drug groups arms, respectively （χ^2 = 3.095, P = 0.08）, sorafenib combined with S-1 Group 3/4 toxicity associated with chemotherapy drugs, aspartate amino trausferase （AST） （18.5%）, thromboeytopenia （14.8%）, the Neutrophilie granuloeytopenia （22.2%）, hand-foot syndrome （22.2%）. Single group 3/4 toxicity manifested as increased AST （3.5%）, Neutrophilic granulocytopenia （6.8%） and skin lesions （3.4%）. Conclusion In our trial, Sorafenib combined with S-1 in treating advanced hepatocellular carcinoma compared with the currently recommended single-agent sorafenib, extends the effective rate to 10.2%, PFS 1.8 months, OS 2.6 months. This treatment is well tolerated, worthy of clinical application and further observation.

关 键 词：晚期肝癌 索拉非尼 替吉奥 疗效 

分 类 号：R735.2[医药卫生—肿瘤]