阿帕替尼对巴塞罗那临床肝癌分类B/C期肝癌的疗效  

The efficacy of apatinib on Barcelona clinic liver cancer stage B/C liver cancer

作　　者：代月黎 欧阳晨雨 方向军 曹怡 DAI Yueli;OUYANG Chenyu;FANG Xiangjun;CAO Yi(Department of Radiology,the Second Affiliated Hospital,Hengyang Medical School,University of South China,Hengyang,Hunan Province 421001,China;Department of Radiology,the First Affiliated Hospital,Hengyang Medical School,University of South China,Hengyang,Hunan Province 421001,China)

机构地区：[1]南华大学衡阳医学院附属第二医院放射科,湖南衡阳421001 [2]南华大学衡阳医学院附属第一医院放射科,湖南衡阳421001

出　　处：《实用放射学杂志》2022年第6期923-927,共5页Journal of Practical Radiology

基　　金：湖南省卫生健康委员会科研课题(202109011222);衡阳市科学技术局指导性项目(S2018F9031022241)。

摘　　要：目的 探讨DC Bead肝动脉化疗栓塞术(DC Bead-TACE)联合阿帕替尼(APA)治疗巴塞罗那临床肝癌分类(BCLC)B/C期肝癌患者的疗效.方法 回顾性收集86例BCLC B/C期肝癌患者资料,根据疗法不同分为单独治疗组(DC Bead-TACE组,n=45)和联合治疗组(DC Bead-TACE+APA组,n=41).观察治疗期间毒副反应,监测治疗前后血清谷丙转氨酶、谷草转氨酶、血清甲胎蛋白和异常凝血酶原Ⅱ(PIVKA-Ⅱ)浓度,评估疗效并随访无进展生存期和总生存期.结果 联合治疗组高血压、手足综合征(HFS)和蛋白尿的发生率高于单独治疗组(P<0.05).治疗后7 d,2组血清谷丙转氨酶和谷草转氨酶浓度较治疗前和治疗后30 d升高(P<0.05).治疗后30 d,2组血清甲胎蛋白和PIVKA-Ⅱ浓度较治疗前降低(P<0.05).治疗前,2组血清甲胎蛋白和PIVKA-Ⅱ浓度差异无统计学意义(P>0.05);治疗后30 d,联合治疗组血清甲胎蛋白和PIVKA-Ⅱ浓度低于单独治疗组(P<0.05).治疗后3个月,联合治疗组客观缓解率高于单独治疗组(χ^(2)=6.583,P=0.010).联合治疗组无进展生存期高于单独治疗组(7个月vs 5个月)(χ^(2)=4.244,P=0.039),总生存期高于单独治疗组(17个月vs 11个月)(χ^(2)=4.683,P=0.030).结论 与DC Bead-TACE治疗相比,DC Bead-TACE联合APA治疗BCLC B/C期肝癌患者疗效更好,延长了无进展生存期和总生存期,容易诱发APA相关毒副反应.Objective To investigate the therapeutic effect of DC Bead transcatheter arterial chemoembolization(DC Bead-TACE)combined with apatinib(APA)in Barcelona clinic liver cancer(BCLC)stage B/C liver cancer patients.Methods Totally 86 patients.with BCLC stage B/C liver cancer were retrospectively collected.Patients were divided into two groups according to different treatment methods:the single treatment group(DC Bead:TACE group,n=45)and the combined treatment group(DC Bead-TACE+APA group,n=41).The side effects during treatment were observed.Serum alanine aminotransferase,aspartate aminotransferase,alpha-fetoprotein,and protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)concentrations before and after treatment were monitored.Efficacy was asssed,while progression free survival and overall survival were both followed up.Results The incidence of hypertension,hand-foot syndrome(HFS)and proteinuria in the combined treatment group were higher than those in the single treatment group(P<0.05).At 7 days after treatment,the concentrations of serum alanine aminotransferase and aspartate aminotransferase in the two groups were higher than those before and 30 days after treatment(P<0.05).At 30 days after treatment,the concentrations of serum alpha fetoprotein and PIVKA-Ⅱ in the two groups were lower than before treatment(P<0.05).Before treatment,there were no significant differences in serum alpha fetoprotein and PIVKA-Ⅱ concentrations between the two groups(P>0.05).At 30 days after treatment,the concentrations of serum alpha fetoprotein and PIVKA-Ⅱ in the combined treatment group were lower than those in the single treatment group(P<0.05).After 3 months of treatment,the objective response rate of the combined treatment group was higher than that of the single treatment group(χ^(2)=6.583,P=0.010).Cumulative progression-free survival was higher in the combined treatment group than that in the single treatment group(7 months vs 5 months)(χ^(2)=4.244,P=0.039).Cumulative overall survival of the combined treatment

关 键 词：阿帕替尼 肝癌 化疗 血供 

分 类 号：R979.1[医药卫生—药品] R735.7[医药卫生—药学] R818.051