聚乙烯醇化疗栓塞联合阿帕替尼治疗晚期原发性肝癌合并动静脉分流的效果  

The curative effect of polyvinyl alcohol interventional chemoembolization combined with apatinib treatment for advanced HCC complicated by arteriovenous shunt

作　　者：曾云建 毛颖民 史自立[1] 周煜奇[1] 张玲芳[1] ZENG Yunjian;MAO Yingmin;SHI Zili;ZHOU Yuqi;ZHANG Lingfang(Minimally Invasive Diagnosis and Treatment Center,Zhejiang Provincial Tongde Hospital,Hangzhou,Zhejiang Province 310012,China)

机构地区：[1]浙江省立同德医院介入微创诊疗中心

出　　处：《介入放射学杂志》2019年第10期949-953,共5页Journal of Interventional Radiology

摘　　要：目的探讨聚乙烯醇(PVA)化疗栓塞联合阿帕替尼治疗晚期原发性肝癌合并动静脉分流的效果。方法选取2015年1月至2017年9月收治的86例晚期肝癌合并动静脉分流患者为研究对象。采用随机数字表法随机分为对照组和观察组,每组各43例。对照组采用PVA经肝动脉化疗栓塞,观察组于每次TACE治疗的3~7 d后口服甲磺酸阿帕替尼。比较两组治疗效果,血清学指标,不良反应和累积生存率。结果观察组疾病控制率高于对照组(65.1%比41.8%),差异有统计学意义(χ^2=4.674,P=0.031)。治疗3个月后,两组甲胎蛋白(AFP)、血管内皮细胞生长因子(VEGF)和成纤维细胞生长因子(FGF)均较治疗前降低(P<0.05),而且观察组降低幅度大于对照组(P<0.05)。观察组中位生存期(OS)大于对照组(13.2个月比7.3个月,P<0.05),对照组和观察组中位无进展生存期(mPFS)大于对照组(6.1个月比4.7个月,P<0.05)。观察组6、12个月累积生存率(79.3%、46.4%)明显高于对照组(63.6%、22.5%),差异有统计学意义(P<0.05)。观察组高血压、蛋白尿发生率高于对照组(P<0.05)。结论PVA TACE联合阿帕替尼治疗晚期肝癌并动静分流是有效的,可改善患者生存期,且安全性较高,不良反应少。Objective To evaluate the curative effect of polyvinyl alcohol(PVA)interventional chemoembolization combined with apatinib in treating advanced hepatocellular carcinoma(HCC)complicated by arteriovenous shunt.Methods A total of 86 patients with advanced HCC complicated by arteriovenous shunt,who were admitted to authors'hospital during the period from January 2015 to September 2017,were enrolled in this study.Using random digital table method,the patients were randomly divided into the control group and the observation group with 43 patients in each group.The patients of the control group received transcatheter arterial chemoembolization(TACE)with PVA,while the patients of the observation group received additional oral apatinib mesylate therapy 3-7 days after each TACE.The curative effect,serological indexes,adverse reactions and cumulative survival rate were compared between the two groups.Results The disease control rate of the observation group was higher than that of the control group(65.1%vs 41.8%),the difference was statistically significant(χ2=4.674,P=0.031).Three months after treatment,the levels of alphafetoprotein(AFP),vascular endothelial growth factor(VEGF)and fibroblast growth factor(FGF)were decreased in both groups when compared with the preoperative ones(P<0.05),and their reduction ranges in the observation group were larger than those in the control group(P<0.05).The median survival time(OS)of the observation group was longer than that of the control group(13.2 months vs 7.3 months,P<0.05).The median progression-free survival(PFS)of the observation group was longer than that of the control group(6.1 months vs 4.7 months,P<0.05).The 6-month and 12-month cumulative survival rates in the observation group were 79.3%and 46.4%respectively,which were significantly higher than 63.6 and 22.5%respectively in the control group,the above differences between the two groups were statistically significant(P<0.05).The incidence of hypertension and albuminuria in the observation group were higher than those in t

关 键 词：聚乙烯醇 阿帕替尼 肝癌 动静分流 治疗效果 

分 类 号：R735.7[医药卫生—肿瘤]