OBJECTIVE:To investigate the efficacy of sorafenib combined with transarterial chemoembolization (TACE) and bronchial transarterial chemoinfusion (TAI) in treatment of hepatocellular carcinoma(HCC) patients with lung metastasis. METHODS:105 cases of HCC patients with pulmonary metastasis were divided into observation group and control group by random number table, 53 cases in control group received TACE and TAI, based on the control group, 52 cases in observation group were additionally treated with sorafenib. Response of treatment, progression-free survival ( PFS) , overall survival ( OS) and adverse reactions and some other indexes were analyzed in two groups. RESULTS:The effective rate in observation group was higher than that in control group, the difference was statistically significant ( P <0. 05 ); the incidence of metastasis in organs except lung in observation group was lower than that in control group, the difference was statistically significant ( P <0. 05 ); also, the mortality in observation group was lower than that in control group, the difference was statistically significant ( P <0. 05 ); in observation group, OS and PFS of the patients were respectively higher than that in control group, the difference was statistically significant ( P <0. 05 ) . The significant prognosticators for OS and PFS were ECOG score, Child-Pugh categorization and treatment response. CONCLUSIONS:The efficacy of of sorafenib combined with TACE and TAI in treatment of HCC patients with lung metastasis is effective, it is worthy of clinic popularization and application.%目的:探讨索拉非尼化疗联合动脉栓塞化疗和动脉灌注化疗对于肝细胞癌肺转移患者的疗效. 方法:将105例患者按照随机数字表法分为观察组和对照组,对照组53例患者给予动脉栓塞化疗和动脉灌注化疗,观察组52例患者在对照组治疗的基础上加用索拉非尼. 对2组患者治疗响应、无进展生存期、总生存期和不良反应等指标进行比较. 结果:观察组患者肝内、肺内总有效率均明显高于对照组,差异有统计学意义(P<0. 05);观察组患者其他部位转移发生率明显低于对照组,差异有统计学意义(P<0. 05).观察组患者死亡率明显低于对照组,差异有统计学意义(P<0. 05);中位总生存期(overall survival,OS)和无进展生存期(progression-Free-Survival,PFS)均明显优于对照组,差异有统计学意义(P<0. 05). ECOG评分、Child-Pugh分级和治疗响应是OS和PFS的显著独立预测因子. 结论:索拉非尼联合动脉栓塞化疗和动脉灌注化疗对肝细胞癌肺转移患者效果较为理想,值得临床推广.
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