TACE联合索拉非尼治疗中晚期肝细胞性肝癌的临床研究

摘要

目的：探讨经导管动脉化疗栓塞（transcatheter arterial chemoembolization，TACE）联合索拉非尼治疗中晚期肝细胞性肝癌（hepatocellular carcinoma，HCC）的疗效及安全性。方法选择我院70例中晚期HCC患者，其中35例给予TACE联合索拉非尼治疗（观察组），35例单纯行TACE治疗（对照组）。每4~8周根据实体瘤疗效评估标准（RECIST）行肿瘤应答评价，评估临床疗效及索拉非尼毒副反应，比较两组患者治疗后的中位生存期及中位疾病进展时间。结果观察组和对照组中位OS分别为14.8个月和8.2个月，差异有统计学意义（P<0.05），中位TTP分别为10.3个月和5.8个月，差异有统计学意义（P<0.05）。观察组服用索拉非尼后有27例（77.1%）患者出现毒副反应，经对症治疗后好转。结论TACE联合索拉非尼治疗中晚期HCC疗效好，不良反应可耐受，有望成为中晚期HCC的一种治疗模式。%Objective To explore the clinical efficacy and adverse reactions associated with transcatheter arterial chemoembolization (TACE)combined with sorafenib in advanced hepatocellular carcinoma (HCC). Methods A total of 70 patients with advanced and late HCC were divided into two treatment groups: one received TACE combined with sorafenib,while the other was treated by TACE alone.Tumor response was assessed every 4-8 weeks using Response Evaluation Criteria for Solid Tumors(RECIST).Clinical efficacy and adverse effects associated with sorafenib were evaluated. Median overall survival(OS)and median time to progression(TTP)were compared between the two groups. Results Median OS was significantly shorter in the combination therapy group(8.2 months) than in the TACE-only group (14.8 months;P<0.05).The combination therapy group also showed significantly shorter median TTP(10.3 months vs 5.8 months,P<0.05).The rate of adverse reactions in the combination therapy group was 77.1%. Conclusions TACE combined with sorafenib is effective for treating patients with advanced and late HCC,and it is associated with tolerable side effects.