索拉非尼单独或联合经动脉化疗栓塞和射频消融治疗复发性肝细胞癌的疗效比较  

Comparative on Efficacy of Sorafenib Alone or Combined with Transcatheter Arterial Chemoembolization and Radiofrequency Ablation in Treamtent of Recurrent Hepatocellular Carcinoma

作　　者：王彦荣[1] 王立波[1] 任既晨 刘明珠[1] WANG Yanrong;WANG Libo;REN Jichen;LIU Mingzhu(Dept.of Abdominal Oncology,Jilin Provincial Cancer Hospital,Jilin Changchun 130012,China)

机构地区：[1]吉林省肿瘤医院腹部肿瘤内二科

出　　处：《中国医院用药评价与分析》2019年第10期1192-1195,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：吉林省卫生计生委科研课题资助项目(No.2016Z027)

摘　　要：目的:回顾性比较索拉非尼单独或联合经动脉化疗栓塞和射频消融治疗复发性肝细胞癌的疗效。方法:选取2014年6月至2019年5月吉林省肿瘤医院收治的298例晚期复发性肝细胞癌患者的临床资料。根据治疗方法不同分为联合组(索拉非尼联合经动脉化疗栓塞和射频消融治疗)152例和对照组(索拉非尼单药治疗)146例。比较两组患者的临床疗效、总生存期(OS)与疾病进展时间(TTP),采用单变量和多变量Cox比例风险模型评价影响患者OS与TTP的相关因素,分析两组患者用药不良反应情况。结果:联合组患者的疾病控制率明显高于对照组[83.6%(127/152)vs.48.0%(70/146)],差异有统计学意义(P<0.001)。联合组患者的OS和TTP明显长于对照组,差异均有统计学意义(P<0.001)。肝内肿瘤数量(HR=2.065,95%CI=1.366~3.099,P=0.001)和联合治疗(HR=1.605,95%CI=1.072~2.402,P=0.023)是OS的独立相关因素,联合治疗(HR=1.462,95%CI=1.019~2.498,P=0.041)是TTP的独立相关因素。两组患者服用索拉非尼引起的手足皮肤反应、腹泻及恶心呕吐等不良反应发生率的差异均无统计学意义(P>0.05)。结论:索拉非尼联合经动脉化疗栓塞和射频消融治疗肝切除术后晚期复发性肝细胞癌的疗效优于单纯索拉非尼治疗,患者耐受性好,且安全性高。OBJECTIVE:To retrospectively compare the efficacy of sorafenib alone or combined with transcatheter arterial chemoembolization(TACE)and radiofrequency ablation(RFA)in treatment of recurrent hepatocellular carcinoma(HCC).METHODS:Clinical data of 298 patients with advanced(HCC)admitted into Jilin Provincial Cancer Hospital from Jun.2014 to May 2019 were selected and divided into combined group(sorafenib combined with TACE and RFA,152 cases)and control group(sorafenib alone,146 cases)according to different therapeutic regimens.The clinical efficacy,overall survival(OS)and time to progression(TTP)were compared between two groups,the univariate and multivariate Cox proportional hazard models were adopted to evaluate related factors affecting OS and TTP,and the incidences of adverse drug reactions of two groups were analyzed.RESULTS:The disease control rate of combined group was significantly higher than that of the control group[83.6%(127/152)vs.48.0%(70/146)],with statistically significant difference(P<0.001).The OS and TTP of combined group were significantly longer than those of the control group,with statistically significant difference(P<0.001).The number of intrahepatic tumor(HR=2.065,95%CI=1.366-3.099,P=0.001)and combined therapy(HR=1.605,95%CI=1.072-2.402,P=0.023)were the independent relevant factors of OS,combined therapy(HR=1.462,95%CI=1.019-2.498,P=0.041)was the independent relevant factor of TTP.There was no statistical significance in difference of incidences of adverse drug reactions of hand-foot-skin reaction,diarrhea,nausea and vomiting induced by sorafenib between two groups(P>0.05).CONCLUSIONS:The efficacy of sorafenib combined with TACE and RFA in treatment of post-hepatectomy advanced recurrent HCC is better than that of sorafenib alone,with better tolerance of patients and high safety.

关 键 词：肝细胞癌 索拉非尼 动脉化疗栓塞 射频消融术 疗效 安全性 

分 类 号：R979.1[医药卫生—药品]