载药微球栓塞联合甲磺酸阿帕替尼治疗中晚期原发性肝癌的近期疗效  

Short-Term Clinical Response of DEB-TACE Combined with Apatinib on Patients with Intermediate-advanced Hepatocellular Carcinoma

作　　者：万源 陈斌[1] 李楠[1] 林润[1] 唐可禺 戴海涛[1] 温春勇 黄勇慧[1] WAN Yuan;CHEN Bin;LI Nan;LIN Run;TANG Ke-yu;DAI Hai-tao;WEN Chun-yong;HUANG Yong-hui(Department of Interventional Radiology,The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院放射介入科,广东广州510080

出　　处：《中山大学学报（医学版）》2019年第3期437-444,共8页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省前沿与关键技术创新专项(2014JDA030;2015B010125004)

摘　　要：【目的】评估载药栓塞微球负载阿霉素联合甲磺酸阿帕替尼治疗中晚期原发性肝癌的安全性和近期疗效。【方法】对本中心采用载药微球经动脉化疗栓塞术(DEB-TACE)联合甲磺酸阿帕替尼治疗的原发性肝癌患者相关资料进行了回顾性分析。所有患者均只进行了1次DEB-TACE治疗,并在DEB-TACE术后推荐开始服用甲磺酸阿帕替尼500 mg治疗。对术前及术后4～8周患者第一次随访的影像随访资料以及肿瘤生物学指标甲胎蛋白(AFP)进行分析,同时观察并记录治疗过程包括服用阿帕替尼在内的不良反应事件。【结果】根据实体瘤疗效评价标准(RECIST)、改良实体瘤疗效评价标准(mRECIST)及欧洲肝脏研究协会标准(EASL)结果显示,这11例患者的客观缓解率(ORR)分别为36.4%、63.6%、72.7%,疾病控制率(DCR)分别为90.7%、72.7%、81.8%。患者术后AFP平均水平为44 251.7μg/L,较术前平均水平366 336μg/L明显下降。有4例患者在服用甲磺酸阿帕替尼后出现Ⅲ级不良反应,其余患者均未出现Ⅳ级不良反应。【结论】使用载药栓塞微球负载阿霉素联合甲磺酸阿帕替尼治疗中晚期原发性肝癌的安全性较高,近期疗效良好。【Objective】To evaluate the safety and effects of transcatheter arterial chemoembolization using Drug-eluted beads(DEB-TACE)plus apatinib in patients with hepatocellular carcinoma(HCC).【Methods】A retrospective analysis was performed,which included 11 HCC patients treated with DEB-TACE and followed by a target therapy of apatinib(500 mg QD)in our clinical research center. Radiograph evaluation and tumor biomarker,alpha-fetoprotein(AFP),were recorded before the procedure and during the follow-up of the first cycle after 4~8 weeks. Adverse events induced by apatinib were recorded.【Results】According to the response evaluation criteria in solid tumors(RECIST),modified response evaluation criteria in solid tumors(mRECIST)and European Association for the study of the liver(EASL)criteria,the objective response rate(ORR)was 36.4%,63.6%,72.7% respectively,and the disease control rate(DCR)was 90.7%,72.7%,81.8% respectively. AFP levels were 44 251.7 μg/L which significantly decreased after the procedure,compared to 366 336 μg/L,the levels before the treatment. Four reversible grade III adverse events were recorded and no grade IV adverse events found in these cases.【Conclusion】According to the short-term treatment response and safety,DEB-TACE combined with apatinib could be considered as a promising treatment for intermediate and advanced stage hepatoma.

关 键 词：DEB-TACE 原发性肝癌 甲磺酸阿帕替尼 

分 类 号：R735[医药卫生—肿瘤]