载药微球栓塞联合索拉非尼治疗不可切除肝癌安全性和疗效  

Safety and efficacy of drug-eluting bead chemoembolization combined with sorafenib in treatment of unresectable liver cancer

作　　者：曹耿飞 张海潇[1] 顾俊鹏[1] 朱帝文[1] 鲍应军 阿斯哈尔·哈斯木 任伟新[1] Cao Gengfei;Zhang Haixiao;Gu Junpeng;Zhu Diwen;Bao Yingjun;Asihaer·hasimu;Ren Weixin(Department of Interventional Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院介入科,乌鲁木齐830054

出　　处：《中华肝脏外科手术学电子杂志》2021年第1期43-47,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

摘　　要：目的探讨载药微球栓塞(DEB-TACE)联合索拉非尼治疗不可切除中晚期原发性肝癌(肝癌)的安全性及疗效。方法回顾性分析2017年4月至2018年9月新疆医科大学第一附属医院采用DEB-TACE联合索拉非尼治疗的31例不可切除中晚期肝癌患者临床资料。其中男24例,女7例;年龄35~78岁,中位年龄55岁。患者均签署知情同意书,符合医学伦理学规定。根据改良版实体瘤疗效评价标准(mRECIST)评价标准评估肿瘤反应,观察DEB-TACE联合索拉非尼的不良反应情况,同时分析患者总体生存、无疾病进展生存情况。结果术后肝脓肿2例,引流后好转;Ⅲ级高血压2例,Ⅲ级腹泻1例,予对症处理并减半服药后可耐受,余患者不良反应可耐受。本组随访时间7~37个月,中位随访时间24个月;27例患者死亡,4例存活。术后1、3、6、12个月的客观缓解率和疾病控制率分别为61.3%、67.8%、64.5%、42.9%和96.8%、90.3%、87.1%、71.4%。中位总体生存期和无疾病进展期分别为25、14个月。结论DEB-TACE联合索拉非尼治疗不可切除中晚期肝癌显示出良好的安全性、耐受性,同时具有更好的临床获益。Objective To evaluate the safety and efficacy of drug-eluting bead-transarterial chemoembolization(DEB-TACE)combined with sorafenib in the treatment of unresectable middle/advancedstage primary liver cancer(PLC).Methods Clinical data of 31 patients with unresectable middle/advancedstage PLC treated with DEB-TACE combined with sorafenib in the First Affiliated Hospital of Xinjiang Medical University from April 2017 to September 2018 were retrospectively analyzed.Among them,24 patients were male and 7 female,aged from 35 to 78 years with a median age of 55 years.The informed consents of all patients were obtained and the local ethical committee approval was received.According to the modified Response Evaluation Criteria in Solid Tumors(mRECIST),the tumor response was evaluated.The adverse events of DEB-TACE combined with sorafenib were observed.The overall survival and diseasefree survival of patients were analyzed.Results 2 patients developed liver abscess after operation,which were mitigated after drainage.2 cases suffered from gradeⅢhypertension and 1 case of gradeⅢdiarrhea,which could be tolerated after symptomatic treatments and half-dose medication.The remaining cases experienced tolerable adverse events.The follow-up time was 7-37 months,with a median time of 24 months.27 cases died and 4 cases survived.The objective response rate and disease control rate at postoperative 1,3,6,12 months were 61.3%,67.8%,64.5%,42.9%,and 96.8%,90.3%,87.1%,71.4%,respectively.The median overall survival and disease-free progression time were 25 and 14 months,respectively.Conclusions DEB-TACE combined with sorafenib yields good safety and tolerance in the treatment of unresectable middle/advancedstage PLC,which can bring favorable clinical benefits.

关 键 词：肝肿瘤 化学栓塞 治疗性 载药微球 索拉非尼 

分 类 号：R735.7[医药卫生—肿瘤]