TACE联合阿帕替尼治疗肝细胞肝癌伴门静脉癌栓疗效研究  

Efficacy analysis of transarterial chemoembolization combined with Apatinib in hepatocellular carcinoma with portal vein tumor thrombus

作　　者：张璐西[1] 吴金平[1] 阮程华 吴康 ZHANG Lu-xi;WU Jin-ping;RUAN Cheng-hua;WU Kang(Department of Interventional Radiology,the Third People's Hospital of Changzhou,Changzhou 213003,Jiangsu,China)

机构地区：[1]常州市第三人民医院介入放射科

出　　处：《生物医学工程与临床》2019年第6期683-687,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的评价经导管肝动脉化疗栓塞术(TACE)联合阿帕替尼治疗肝细胞肝癌(HCC)伴门静脉癌栓(PVTT)的疗效,为临床治疗提供依据。方法选择48例HCC伴PVTT患者,其中男性43例,女性5例;年龄43~68岁,平均年龄56.2岁;慢性乙型肝炎35例,慢性丙型肝炎3例,酒精肝病4例,其他6例;巨块型肿瘤27例,浸润型肿瘤11例,多发结节型肿瘤10例。依据治疗方法的不同分为2组。A组25例接受TACE联合阿帕替尼治疗,其中男性23例,女性2例;年龄43~65岁,平均年龄54.1岁。B组23例接受单纯TACE治疗,其中男性20例,女性3例;年龄48~68岁,平均年龄57.3岁。A组再按照PVTT的不同类型分为A1组、A2组:主干PVTT组(A1组)11例,分支PVTT组(A2组)14例。评价指标为客观缓解率(ORR)、中位总生存时间(MOS)、中位肿瘤进展时间(MTTP)。结果 3个月内疾病控制指标ORR值比较,A组与B组差异无统计学意义(36.0%vs 30.4%;χ^2=0.328,P> 0.05);A1组与A2组比较,差异无统计学意义(18.2%vs 50.0%;χ^2=7.317,P> 0.05)。各组间MOS相比较,B组MOS短于A组(7.8个月vs 12.1个月),差异有统计学意义(χ^2=4.753,P <0.05);A1组MOS短于A2组(5.1个月vs 13.2个月),差异有统计学意义(χ^2=14.579,P <0.05)。各组间MTTP相比较,B组MTTP短于A组(2.7个月vs 5.2个月),差异有统计学意义(χ^2=12.8,P <0.05);A1组MTTP短于A2组(2.8个月vs 5.8个月),差异有统计学意义(χ^2=14.2,P <0.05)。结论 TACE联合阿帕替尼治疗伴PVTT的HCC安全有效,优于单纯TACE,延长其MOS和MTTP;伴有分支PVTT的HCC的疗效优于伴有主干PVTT的HCC。Objective To evaluate the efficacy of transarterial chemoembolization(TACE) combined with Apatinib in treatment of hepatocellular carcinoma(HCC) patients with portal vein tumor thrombus(PVTT), and provide basis for clinic treatment.Methods A total of 48 HCC patients with PVTT were enrolled, which included 43 males and 5 females, aged 43-68 years old with mean age of 56.2 years old. There were 35 cases of chronic hepatitis B, 3 of chronic hepatitis C, 4 of alcoholic liver disease and 6 of other diseases;27 cases of massive tumors, 11 of invasive tumors and 10 of multiple nodular tumors.According to different treatment methods, the patients were divided into group A(n = 25, which included 23 males and 2 females,aged 43-65 years old with mean age of 54.1 years old, performed TACE combined with Apatinib) and group B(n = 23, which included 20 males and 3 females, aged 48-68 years old with mean age of 57.3 years old, performed TACE therapy).According to different types of PVTT, group A was divided into 2 subgroups, the main PVTT group(group A1, n = 11) and branch PVTT group(group A2, n = 14). The evaluation indexes included objective response rate(ORR), median overall survival time(MOS) and median time to progression(MTTP). Results The ORR value of disease control indicators in 3-month was no statistically significant difference between group A and group B(36.0 % vs 30.4 %;χ^2= 0.328, P > 0.05), and no statistically significant difference between group A1 and group A2(18.2 % vs 50.0 %;χ^2= 7.317, P > 0.05). For MOS, group B was shorter than that of group A(7.8-month vs 12.1-month), and was statistically significant difference(χ^2= 4.753, P < 0.05);group A1 was shorter than that of group A2(5.1-month vs 13.2-month), and was statistically significant difference(χ^2= 14.579, P < 0.05). For MTTP, group B was shorter than that of group A(2.7-month vs 5.2-month), and was statistically significant difference(χ^2=12.8, P < 0.05);group A1 was shorter than that of group A2(2.8-month vs 5.8-month), and was statistically sign

关 键 词：经导管肝动脉化疗栓塞术 阿帕替尼 肝癌 肝肿瘤 治疗效果 门静脉癌栓 

分 类 号：R735.7[医药卫生—肿瘤]