恩替卡韦联合肝动脉化疗栓塞术治疗乙型肝炎病毒相关性肝癌的疗效评价

摘要

Objective:To observe the efficacy of entecavir combined with transcatheter arterial chemoembolization (TACE) in the treatment of hepatitis B virus-related hepatocellular carcinoma (HBVR-HCC).Methods:The totally-enrolled 76 patients with HB-VR-HCC were randomly divided into observation group and control group,38 cases in each group.The patients in control group were treated with TACE alone,while those in observation group were added entecavir.The levels of alanine aminotransferase (ALT),HBeAg negative-conversion rate and conversion rate as well as HBV DNA value were all compared between two groups before and 4,12,24,48 weeks after treatment.Results:ALT levels in two groups improved by varying degrees with time went on.12,24 and 48 weeks after treatment,the ALT level in observation group was significantly lower than that before treatment (P ＜ 0.01),and ALT levels 24 and 48 weeks after treatment were markedly lower than that in control group (P ＜ 0.01).HBV DNA value in observation group went down gradually as time went on,while that in control group didn't change obviously (P ＞ 0.05).HBeAg negative-conversion rate,objective remission rate (ORR) and disease control rate (DCR) at the time of 48 weeks in observation group were all higher than those in control group (P ＜ 0.05).The overall survival (OS) and progression-free survival (PFS) in observation group were obviously longer than those in control group,and the differences were statistically significant (P ＜ 0.05).Conclusion:For the patients with HBVR-HCC,entecavir combined with TACE can effectively inhibit or remove HBV,promote ALT normalization and HBeAg conversion so as to improve the prognosis.%目的:观察恩替卡韦联合肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗乙型肝炎病毒相关性肝癌(hepatitis B virus-related hepatocellular carcinoma,HBVR-HCC)的临床疗效.方法:收集HBVR-HCC患者76例,随机分为观察组和对照组,各38例.对照组采用TACE治疗,观察组加用恩替卡韦,比较丽组治疗前后4、12、24、48周时丙氨酸氨基转移酶(ALT)、HBeAg阴转率和转换率及HBV DNA值.结果:随着治疗时间的延长,2组ALT水平均有不同程度的改善;观察组ALT水平在治疗12周、24周、48周明显低于治疗前(P＜0.01),且24周、48周时显著低于对照组(P＜0.01).观察组HBV DNA值随着治疗时间的延长逐渐降低,对照组HBV DNA值无显著变化(P＞0.05).观察组48周时HBeAg阴转率、客观缓解率(ORR)及疾病控制率(DCR)均明显高于对照组(P＜0.05).观察组总生存期(OS)、无进展生存期(PFS)均较对照组明显延长,差异有统计学意义(P＜0.05).结论:恩替卡韦联合TACE治疗HBVR-HCC患者能有效抑制或消除HBV,促进ALT复常和HBeAg转换,改善患者预后.