动脉化疗栓塞联合阿帕替尼治疗原发性肝癌伴门静脉瘤栓71例疗效分析  

Curative effect of transarterial chemoembolization combined Apatinib in primary liver carcinoma with portal vein tumor thrombus in 71 Cases

作　　者：吴雨哲 胡少勃 程翔[1] 高杨 王为民 郑启昌[1] WU Yuzhe;HU Shaobo;CHENG Xiang;GAO Yang;WANG Weimin;ZHENG Qichang(Department of Hepatobiliary Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院肝胆外科,湖北武汉430022

出　　处：《安徽医药》2021年第6期1118-1120,共3页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金资助项目(81372668)。

摘　　要：目的探讨动脉化疗栓塞(TACE)联合阿帕替尼治疗原发性肝癌伴门静脉瘤栓疗效及安全性。方法选择2016年1月至2017年6月华中科技大学同济医学院附属协和医院诊治的149例原发性肝癌伴门静脉瘤栓病人为研究对象,根据病人治疗方法分为TACE联合阿帕替尼组(71例)和单纯TACE组(78例),多因素Cox风险比例模型、生存曲线及log-rank检验用来比较两组疗效及总生存期的区别。结果多因素Cox风险比例模型证实联合阿帕替尼是肝癌预后的保护因素HR(95%CI):0.415(0.236~0.735),P=0.003,生存曲线及log-rank检验证实TACE联合阿帕替尼组中位生存期显著高于单纯TACE组[(18.4±2.8)月比(13.6±1.2)月,P<0.001]。TACE联合阿帕替尼组高血压、手足皮肤反应、蛋白尿并发症发生率高于单纯TACE组(P<0.05),在消化道症状、骨髓抑制及肝功能损伤方面的差异无统计学意义(P<0.05)。结论阿帕替尼联合TACE治疗原发性肝癌伴门静脉瘤栓病人疗效显著优于单纯TACE治疗,具有高效安全等优点。Objective To explore the curative effect and safety of transarterial chemoembolization(TACE)combined Apatinib in treating primary liver cancer(PLC)with portal vein tumor thrombus(PVTT).Methods From January 2016 to June 2017,149 patients of primary liver cancer combined with portal vein tumor thrombus,diagnosed and treated in Union Hospital of Tongji Medical College,Huazhong University of Science and Technology,were selected as the research objects.Patients were assigned into TACE combined with apatinib group(n=71)and TACE-alone group(n=78)according to the therapies.Multivariate Cox proportional hazards models,survival curve and log-rank test were used to compare the efficacies and the overall survival between the two groups.Results Multivariate Cox proportional hazards models verified that Apatinib was a protective factor for PLC with PVTT[HR(95%CI):0.415(0.236-0.735),P=0.003].Survival curve and log-rank test verified that the median survival time of patients treated by TACE combined Apatinib was significantly longer than TACE-alone group[(18.4±2.8)months vs.(13.6±1.2)months,P<0.001].The incidence rates of hypertension,hand-foot-skin reaction,and proteinuria in the TACE combined with apatinib group were higher than those in the TACE-alone group(P<0.05),and there were no statistically significant differences in gastrointestinal symptoms,bone marrow suppression and liver damage(P<0.05).Conclusion Apatinib combined with TACE in the treatment of primary liver cancer combined with portal vein tumor thrombosis achieves better efficacy than TACE alone,which has the advantages of high efficiency and safety.

关 键 词：肝肿瘤 化学栓塞 治疗性 门静脉瘤栓 阿帕替尼 疗效 

分 类 号：R735.7[医药卫生—肿瘤]