TACE联合索拉非尼治疗不能手术切除肝细胞癌的不良反应与疗效

摘要

目的 评价TACE联合索拉非尼治疗不能手术切除肝细胞癌(HCC)的不良反应与疗效的关系.方法 对50例不能手术切除的HCC患者行TACE联合索拉非尼治疗,观察疾病进展时间和索拉非尼的不良反应.结果 至随访截止日36例患者存活.46例(46/50,92.00％)患者服用索拉非尼出现不同程度的不良反应,包括手足皮肤反应29例(29/50,58.00％)、乏力27例(27/50,54.00％)、腹泻20例(20/50,40.00％)、高血压19例(19/50,38.00％)等.出现中、重度不良反应的患者较轻度或无不良反应者中位疾病进展时间(mTTP)延长了138天(x2=5.08,P=0.02),出现手足皮肤反应者的mTTP较未出现者延长了140天(x2=6.64,P=0.01).结论 TACE联合索拉非尼治疗不能手术切除HCC的不良反应多可耐受.出现中、重度不良反应可延长疾病进展时间.出现手足皮肤反应提示预后较好.%Objective To evaluate the efficacy and adverse reactions of TACE combined with Sorafenib in treatment of unresectable hepatocellular carcinoma (HCC). Methods Fifty patients with unresectable HCC underwent treatment by TACE combined with Sorafenib. Time to progression and adverse reactions of Sorafenib were observed. Results Thirty-six patients were survived at the end of follow-up. There were 46 (46/50, 92. 00%) patients receiving Sorafenib experienced adverse reactions in various degrees, mainly including 29 patients (29/50, 58. 00%) of hand-foot syndrome (HFS), 27 (27/50, 54.00%) of fatigue, 20 (20/50, 40.00%) of diarrhea and 19 (19/50, 38.00%) of hypertension. The median TTP (mTTP) of patients experienced moderate or severe adverse reactions extended 138 days compared with that of patients experienced mild or none adverse reactions (x2 =5. 08, P = 0. 02). The mTTP of patients with HFS extended 140 days compared with that of patients without HFS (x2 =6. 64, P = 0. 01). Conclusion The adverse reactions of TACE combined with Sorafenib in treatment of unresectable HCC majority can be tolerated. The TTP of patients with moderate to severe adverse reactions significantly extended, indicating a good prognosis for patients with HFS.