HAIC联合阿帕替尼治疗巨块型肝细胞癌合并门静脉癌栓的疗效分析  

Analysis of the therapeutic effect of HAIC combined with apatinib in the treatment of massive hepatocellular carcinoma with portal vein tumor thrombus

作　　者：刘振华 蔡联明 袁福建 赖海平 吴向欣 LIU Zhen-hua;CAI Lian-ming;YUAN Fujian(Ganzhou Cancer Hospital,Ganzhou 341000,China)

机构地区：[1]赣州市肿瘤医院腹部外科,341000

出　　处：《中国实用医药》2025年第2期117-120,共4页China Practical Medicine

摘　　要：目的分析肝动脉灌注化疗(HAIC)联合阿帕替尼治疗巨块型肝细胞癌(HCC)合并门静脉癌栓(PVTT)的疗效。方法60例巨块型HCC伴PVTT患者,随机分为对照组和观察组,每组30例。对照组行HAIC治疗,观察组于对照组基础上增加阿帕替尼治疗。比较两组患者临床疗效、肝功能指标、不良反应发生情况、生存情况、生存质量。结果观察组完全缓解(CR)4例(13.3%)、部分缓解(PR)14例(46.7%)、病情稳定(SD)6例(20.0%)、疾病进展(PD)6例(20.0%),总有效率为60.0%;对照组CR 2例(6.7%)、PR 8例(26.7%)、SD 8例(26.7%)、PD 12例(40.0%),总有效率为33.3%;观察组治疗总有效率高于对照组,差异明显(P<0.05)。治疗后,观察组丙氨酸氨基转移酶(ALT)为(36.1±4.1)U/L、天门冬氨酸氨基转移酶(AST)为(38.4±6.4)U/L、白蛋白(ALB)为(38.5±3.9)g/L,对照组患者ALT为(45.3±3.6)U/L、AST为(49.6±7.1)U/L、ALB为(36.2±3.1)g/L。观察组ALT、AST水平低于对照组,ALB水平高于对照组,差异明显(P<0.05)。观察组不良反应发生率略低于对照组,但差异不明显(P>0.05)。对照组治疗1年后有22例生存、占比73.3%,治疗2年后有14例生存、占比46.7%,治疗3年后有7例生存、占比23.3%,生存时间(3.5±1.4)年;观察组治疗1年后有28例生存、占比93.3%,治疗2年后有23例生存、占比76.7%,治疗3年后有18例生存、占比60.0%,生存时间(4.6±1.2)年。观察组治疗1、2、3年后生存率均高于对照组,生存时间长于对照组,差异明显(χ^(2)/t=4.320、5.711,8.297、3.267,P<0.05)。治疗后,观察组患者社会功能、情感功能、生理功能、躯体疼痛、活力、精神健康、总体健康评分均高于对照组,差异明显(P<0.05)。结论针对巨块型HCC伴PVTT选择HAIC联合阿帕替尼治疗效果显著。Objective To analyze the therapeutic effect of hepatic arterial infusion chemotherapy(HAIC)combined with apatinib in the treatment of massive hepatocellular carcinoma(HCC)with portal vein tumor thrombus(PVTT).Methods 60 patients with massive HCC and PVTT were randomly divided into a control group and an observation group,each consisting of 30 patients.The control group was treated with HAIC treatment alone,and the observation group was treated with apatinib on the basis of the control group.The clinical efficacy,liver function index,occurrence of adverse reactions,survival and quality of life of the two groups were compared.Results In the observation group,there were 4 cases(13.3%)of complete response(CR),14 cases(46.7%)of partial response(PR),6 cases(20.0%)of stable disease(SD),and 6 cases(20.0%)of progressive disease(PD),with a total response rate of 60.0%.In the control group,there were 2 cases(6.7%)of CR,8 cases(26.7%)of PR,8 cases(26.7%)of SD and 12 cases(40.0%)of PD,with a total response rate of 33.3%.The total response rate of the observation group was higher than that of the control group,and the difference was significant(P<0.05).After treatment,the observation group had an alanine transaminase(ALT)of(36.1±4.1)U/L,an aspartate transaminase(AST)of(38.4±6.4)U/L and an albumin(ALB)of(38.5±3.9)g/L;the control group had an ALT of(45.3±3.6)U/L,an AST of(49.6±7.1)U/L and an ALB of(36.2±3.1)g/L.The levels of ALT and AST in the observation group were significantly lower than those in the control group,and ALB level was higher than that in the control group.The difference was significant(P<0.05).The incidence of adverse reactions in the observation group was slightly lower than that in the control group,but the difference was not significant(P>0.05).In the control group,22 patients survived 1 year after treatment,accounting for 73.3%;14 patients survived 2 years after treatment,accounting for 46.7%;7 patients survived 3 years after treatment,accounting for 23.3%;the survival time was(3.5±1.4)years.In the ob

关 键 词：门静脉癌栓 巨块型肝细胞癌 阿帕替尼 肝动脉灌注化疗 生存质量 疗效 

分 类 号：R735.7[医药卫生—肿瘤]