TACE联合索拉非尼或阿帕替尼治疗中晚期肝细胞癌  

TACE combined with Sorafenib or Apatinib for treatment of advanced hepatocellular carcinoma

作　　者：杨彦鸿 曹碧辉 陈德基[1] YANG Yanhong;CAO Bihui;CHEN Deji(Department of Minimally Invasive Interventional Radiology,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院微创介入科

出　　处：《中国介入影像与治疗学》2019年第12期735-740,共6页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的对比TACE联合索拉非尼或阿帕替尼治疗中晚期肝细胞癌(HCC)的临床效果。方法回顾性分析73例中晚期HCC,其中41例接受TACE联合索拉非尼治疗(S组)、32例(A组)接受TACE联合阿帕替尼治疗,对比2组疗效、安全性及预后。结果治疗1、3、6、12个月时,2组肿瘤客观缓解率(ORR)及疾病控制率(DCR)差异均无统计学意义(P均>0.05)。A组20例因出现手足综合征、腹痛、食欲减退等而调整用药剂量,其中9例停药;S组6例因手足综合征及蛋白尿而调整剂量,无停药病例。调整剂量前,A组不良事件(AE)少于S组(P<0.01);调整剂量后,2组AE差异无统计学意义(P=0.20)。A组治疗6、12、18个月时无疾病进展率分别为31.25%(10/32)、6.25%(2/32)、3.13%(1/32),S组分别为39.02%(16/41)、19.51%(8/41)、9.76%(4/41),组间差异有统计学意义(χ^2=5.18,P=0.02)。结论 TACE联合索拉非尼治疗中晚期HCC效果好于TACE联合阿帕替尼,且安全性更优。Objective To comparatively analyze the effect of TACE combined with Sorafenib or Apatinib in treatment of advanced hepatocellular carcinoma(HCC). Methods Data of 73 patients with advanced HCC were retrospectively analyzed, including 41 underwent TACE combined with Sorafenib(group S) and 32 underwent TACE combined with Apatinib(group A). The therapeutic efficacy, safety and prognosis were compared between 2 groups. Results No significant difference of object response rate(ORR) nor disease control rate(DCR) was detected between 2 groups after 1, 3, 6 and 12 months’ treatment(all P>0.05). Dose adjustment occurred in 20 patients in group A mainly due to the occurrence of hand-foot syndrome, abdominal pain and loss of appetite, and drug discontinued in 9 cases among them. Meanwhile, dose adjustment happened in 6 cases of group S, mainly because of hand-foot syndrome and proteinuria, and no withdrawal occurred in group S. Before dose adjustment, adverse events(AE) in A group was less than in group S(P<0.01). After dose adjustment, no significant difference of AE was found between 2 groups(P=0.20). The progression free survival(PFS) rate of 6, 12 and 18 months was 31.25%(10/32), 6.25%(2/32) and 3.13%(1/32) of group A, respectively, while was 39.02%(16/41),19.51%(8/41) and 9.76%(4/41) of group S(χ^2=5.18, P=0.02). Conclusion TACE combined with Sorafenib has better effect and safety for treatment of advanced HCC than TACE plus Apatinib.

关 键 词：癌 肝细胞 血管内皮生长因子 化学栓塞 治疗性 阿帕替尼 索拉非尼 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]