阿帕替尼联合经肝动脉化疗栓塞术治疗老年中晚期原发性肝癌临床观察  

Clinical observation of apatinib combined with transcatheter arterial chemoembolization in the treatment of elderly patients with advanced primary liver cancer

作　　者：李风成 程君[2] 谭林[1] 高学武[1] 王金玲[1] 徐静[1] 李莎莎[1] 姜宁[1] LI Feng-cheng;Cheng Jun;TAN Lin;GAO Xue-wu;WANG Jin-ling;XU Jing;LI Sha-sha;JIANG Ning(Department of Hepatology,the Second People’s Hospital of Fuyang City,Fuyang 236015,China;Department of Infection,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]阜阳市第二人民医院肝病科二病区,安徽省阜阳市236015 [2]安徽医科大学第一附属医院感染科,安徽省合肥市230022

出　　处：《实用老年医学》2020年第8期832-835,共4页Practical Geriatrics

摘　　要：目的观察阿帕替尼联合经肝动脉化疗栓塞术(TACE)治疗老年中晚期原发性肝癌(PLC)的效果与安全性。方法前瞻性入组我院2017年12月至2018年12月老年肝癌TNM分期ⅢA和ⅢB期的PLC病人152例,根据病人意愿分为2组,对照组81例采用TACE治疗,观察组71例采用TACE联合阿帕替尼治疗,病人均于治疗后3、6、9个月门诊CT复查。病人均随访至2019年5月或死亡,比较2组病人生存期和治疗期间不良反应发生率。结果观察组和对照组TACE术后3个月客观缓解率(ORR)分别为61.97%、56.79%,差异无统计学意义(P>0.05)。观察组术后6、12个月ORR分别为59.15%、39.44%,均高于对照组的48.15%、11.11%,差异有统计学意义(P<0.05)。观察组中位生存时间为17.09个月,对照组为12.65个月,2组生存曲线差异有统计学意义(χ^2=7.126,P=0.006)。观察组病理性血压升高、手足综合征、蛋白尿、腹泻发生率分别为60.56%、49.30%、33.80%、25.35%,均显著高于对照组(P<0.05)。2组骨髓抑制、发热、疼痛、恶心呕吐发生率差异无统计学意义(P>0.05)。结论阿帕替尼联合TACE治疗中晚期PLC可提高疗效,延长病人生存期,虽然一些不良反应发生率增加,但病人获益更大。Objective To observe the efficacy and safety of apatinib combined with transcatheter arterial chemoembolization(TACE)in the treatment of advanced primary liver cancer(PLC)in the elderly patients.Methods A total of 152 hospitalized PLC patients,TNM stagingⅢA andⅢB period,were selected from December 2017 to December 2018.According to patients’willingness,all the patients were divided into two groups.In the control group,81 cases were treated with TACE,while 71 patients in the observation group received TACE combined with apatinib.All the patients after 3,6,9 months of treatment received outpatient CT scan to review curative effect.The patients were followed up to May 2019 or the end point of death.The incidence of adverse reactions during treatment was observed and compared between the two groups.Results The objective response rate(ORR)of the observation group and the control group were 61.97%and 56.79%respectively 3 months after TACE,with no statistically significant difference(P>0.05).The ORR in the observation group 6 months and 12 months after treatment were 59.15%and 39.44%respectively,compared with 48.15%and 11.11%in the control group(P<0.05).The median survival time of the observation group was 17.09 months,and the median survival time of the control group was 12.65 months.The survival curve of the two groups was statistically different(χ^2=7.126,P=0.006).The incidence rate of pathdogical hypertension,hand and foot syndrome,proteinuria,and diarrhea in the observation group was 60.56%,49.30%,33.80%,and 25.35%,respectively,which were higher than those in the control group(9.88%,0,0,and 8.64%,P<0.05).There was no significant difference in the incidence of bone marrow suppression,fever,pain,nausea and vomiting between the two groups(P>0.05).Conclusions Apatinib combined with TACE in the treatment for advanced PLC can improve the efficacy and prolong the survival time of the patients.

关 键 词：阿帕替尼 经肝动脉化疗栓塞术 原发性肝癌 老年人 

分 类 号：R735.7[医药卫生—肿瘤]