不同剂量阿帕替尼联合经动脉化疗栓塞治疗中晚期原发性肝癌的临床效果及安全性  

Clinical efficacy and safety of different doses of apatinib combined with transarterial chemoembolization in advanced primary hepatocellular carcinoma

作　　者：吴培生[1] 罗永香[1] 陈斯欢 WU Pei-sheng;LUO Yong-xiang;CHEN Si-huan(Department of General Surgery,the First People′s Hospital of Qinzhou,Qinzhou 535000,China)

机构地区：[1]广西钦州市第一人民医院普外科,钦州市535000

出　　处：《广西医学》2020年第3期293-296,301,共5页Guangxi Medical Journal

摘　　要：目的比较不同剂量阿帕替尼联合经动脉化疗栓塞(TACE)治疗对中晚期原发性肝癌的临床效果及安全性。方法将90例中晚期原发性肝癌患者分为观察Ⅰ组、观察Ⅱ组、对照组,各30例。3组均行TACE治疗,观察Ⅰ组、观察Ⅱ组术后分别口服阿帕替尼550 mg/次、300 mg/次治疗。比较3组患者在治疗后1、6、12个月的客观缓解率(ORR),以及无进展生存期和不良反应发生情况。结果观察Ⅰ组及观察Ⅱ组治疗后第6、12个月的ORR均高于对照组,且中位无进展生存期长于对照组(均P<0.05),但观察Ⅰ组及观察Ⅱ组的ORR及中位无进展生存期差异均无统计学意义(均P>0.05)。观察Ⅰ组及观察Ⅱ组的血压升高、手足反应、蛋白尿、腹泻的发生率均高于对照组(均P<005),但观察Ⅰ组与观察Ⅱ组以上指标差异均无统计学意义(均P>0.05)。结论与单纯TACE比较,TACE术后联合阿帕替尼治疗可提高中晚期原发性肝癌患者的中远期疗效,但治疗效果与阿帕替尼剂量的关系不大。Objective To compare the clinical efficacy and safety of different doses of apatinib combined with transarterial chemoembolization(TACE)in advanced primary hepatocellulaRcarcinoma(PHC).Methods Ninety patients with advanced PHC were divided into observation groupⅠ(n=30),observation groupⅡ(n=30)and control group(n=30).The three groups underwent TACE;besides,the observation groupsⅠandⅡwere administered orally apatinib 550 mg peRtime and 300 mg peRtime afteRoperation,respectively.The objective response rates(ORRs)at the 1st,6th and 12th month afteRtreatment,as well as progression-free survival and incidence of adverse reactions,were compared among the three groups.Results The observation groupsⅠandⅡobtained higheRORRs at the 6th and 12th month afteRtreatment,as well as longeRmedian progression-free survival as compared with the control group(all P<0.05),whereas no statistically significant difference was found between the observation groupsⅠandⅡin ORRoRmedian progression-free survival(all P>0.05).The incidence rates of blood pressure elevation,hand-foot reaction,proteinuria and diarrhea in the observation groupsⅠandⅡwere higheRthan the rates in the control group(all P<005),but there was no statistically significant difference between the observation groupsⅠandⅡin the indexes mentioned above(all P>0.05).Conclusions Compared with TACE alone,combination of apatinib afteRTACE can improve mid-and long-term efficacy in advanced PHC patients,but the effect is not closely related to the therapeutic dose of apatinib.

关 键 词：原发性肝癌 中晚期 阿帕替尼 动脉化疗栓塞 介入治疗 药物剂量 疗效 不良反应 安全性 

分 类 号：R45[医药卫生—治疗学] R735.7[医药卫生—临床医学]