载药微球经动脉化疗栓塞与传统肝动脉化疗栓塞分别联合索拉非尼治疗中晚期肝细胞肝癌的有效性和安全性对比  

Comparison of efficacy and safety of DEB-TACE and cTACE combined with sorafenib in the treatment of advanced hepatocellular carcinoma

作　　者：徐仁良[1] 沈松柏[1] 余龙伍[1] 华双一[1] 吴扬 徐标 李春[1] XU Renliang;SHEN Songbai;YU Longwu(Department of Interventional and Vascular Surgery,Naval Anqing Hospital of the Chinese People’s Liberation Army,Anhui,Anqing 246003,China)

机构地区：[1]中国人民解放军海军安庆医院介入与血管外科,246003

出　　处：《临床外科杂志》2023年第4期383-386,共4页Journal of Clinical Surgery

摘　　要：目的探究载药微球经动脉化疗栓塞(DEB-TACE)与传统肝动脉化疗栓塞(cTACE)分别联合索拉非尼治疗中晚期肝细胞肝癌的有效性和安全性。方法2019年3月~2021年3月收治的中晚期肝细胞肝癌病人106例,依照随机数表法分为两组。对照组采用cTACE联合索拉非尼治疗,研究组采用DEB-TACE联合索拉非尼治疗。比较两组病人临床疗效,血清低氧诱导因子1α(HIF-1α)、甲胎蛋白(AFP)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)水平,不良反应及生存状况。结果研究组客观缓解率为64.15%,高于对照组的43.40%,差异有统计学意义(P<0.05);治疗3个月后,两组血清HIF-1α、AFP水平均降低,研究组更低,差异有统计学意义(P<0.05);治疗3个月后,两组血清TBIL、ALT、AST水平均升高,研究组血清TBIL、ALT、AST水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率无明显差异(P>0.05);研究组和对照组病人中位无进展生存时间分别为12.11个月(95%CI 7.78~16.22)和10.09个月(95%CI 7.67~12.33),两组中位无进展生存曲线比较,差异无统计学意义(χ^(2)=2.293,P=0.130)。结论DEB-TACE联合索拉非尼用于治疗中晚期肝细胞肝癌病人能够提高治疗效果,调节血清肿瘤标志物水平,减轻肝损伤。Objective To explore the efficacy and safety of drug-loaded microspheres transarterial chemoembolization(DEB-TACE)and conventional hepatic arterial chemoembolization(cTACE)combined with sorafenib in the treatment of advanced hepatocellular carcinoma.Methods From March 2019 to March 2021,106 patients with advanced hepatocellular carcinoma were included in the study and were randomly divided into two groups according to the random number table method.The control group was treated with cTACE combined with sorafenib,and the study group was treated with DEB-TACE combined with sorafenib.The clinical efficacy,serum hypoxia-inducible factor 1α(HIF-1α),alpha-fetoprotein(AFP),total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)levels,and adverse reactions and living conditions were compared in both groups.Results The objective remission rate in the study group was 64.15%,higher than that in the control group(43.40%)(P<0.05).After 3 months of treatment,serum HIF-1αand AFP levels in both groups were decreased,and the research group was lower(P<0.05).After 3 months of treatment,the levels of serum TBIL,ALT and AST in both groups were increased(P<0.05),and serum levels of TBIL,ALT and AST in the study group were lower than the control group(P<0.05).The difference in the incidence of adverse reactions was not significant in both groups(P>0.05).The median progression-free survival time of study group and control group was 12.11 months(95%CI 7.78-16.22)and 10.09 months(95%CI 7.67-12.33),respectively.There was no significant difference in the median progression-free survival curve between the two groups(χ^(2)=2.293,P=0.130).Conclusion DEB-TACE combined with sorafenib in the treatment of patients with advanced hepatocellular carcinoma can improve the therapeutic effect,regulate the level of serum tumor markers,improve reduce liver damage.

关 键 词：载药微球经动脉化疗栓塞 传统肝动脉化疗栓塞 索拉非尼 肝癌 

分 类 号：R735.7[医药卫生—肿瘤]