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肝动脉化疗栓塞联合索拉非尼治疗中期肝细胞癌患者的安全性及疗效
曲岩,晏建军,黄亮,徐峰,孙经建,严以群*
0
(第二军医大学东方肝胆外科医院肝外一科,上海 200438
*通信作者)
摘要:
目的 评估肝动脉化疗栓塞术(TACE)后联合索拉非尼治疗非手术切除的中期肝细胞癌(HCC)患者的安全性及临床疗效。方法 2009年7月至2011年7月,我院共38例中期HCC患者(试验组)行TACE后索拉非尼联合治疗。根据试验组患者的基本属性及肿瘤特性,从同期选取38例单纯行TACE治疗的中期HCC患者作为对照组进行回顾性研究,所有患者为巴塞罗那肝癌临床分期(BCLC) B期。分析试验组药物相关不良反应及两组总体生存期的差异。结果 所有试验组患者都发生了至少1种药物相关的不良反应,7例(18.4%)患者出现了3级药物相关的不良反应,未见4级及更高的不良反应出现。对照组的中位生存期为11个月(95% CI:7.4~14.6 个月),试验组的中位生存期为15个月(95%CI: 8.4~21.6个月),两组生存期的差异有统计学意义(P=0.019)。 结论 非手术切除的中期HCC患者接受TACE后联合索拉非尼治疗,未见严重不良反应发生且能有效提高患者的总体生存期。
关键词:  肝肿瘤  治疗性化学栓塞  索拉非尼  治疗结果
DOI:
投稿时间:2013-03-26修订日期:2013-05-29
基金项目:国家自然科学基金(81272664).
Transarterial chemoembolization combined with sorafenib in treatment of middle stage hepatocellular carcinoma: efficacy and safety
QU Yan,YAN Jian-jun,HUANG Liang,XU Feng,SUN Jing-jian,YAN Yi-qun*
(Department of Hepatic SurgeryⅠ, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
*Corresponding author.)
Abstract:
Objective To evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with sorafenib in treatment of patients with non-resected middle stage hepatocellular carcinoma (HCC). Methods From July 2009 to July 2011, 38 middle stage HCC patients treated with TACE plus sorafenib were included in the TACE+sorafenib group and the other 38 patients with similar baseline characteristics receiving TACE alone were selected in the TACE group. All the patients belonged to the Barcelona Clinic Liver Cancer (BCLC) stage B. The adverse events of the TACE+sorafenib group and the overall survival of the two groups were analyzed. Results All the patients treated with sorafenib experienced at least one drug-related adverse event during the study, including 7 (18.4%) experienced drug-related grade 3 adverse events, with no grade 4 or higher adverse events occurred. The median overall survival time was 11 months (95% CI: 7.4-14.6 months) for the TACE group and 15 months (95% CI: 8.4-21.6 months) for the TACE+sorafenib group, showing significant difference between the two groups (P=0.019). Conclusion The combination of sorafenib with TACE is well tolerated in non-resected middle stage HCC patients, with no severe adverse events and can effectively improve the overall survival time of patients.
Key words:  liver neoplasms  therapeutic chemoembolization  sorafenib  treatment outcome