TACE联合索拉非尼治疗不可手术切除的肝癌

发布时间：2018-02-26 20:09

本文关键词： 肝肿瘤化学栓塞治疗性分子靶向治疗索拉非尼　出处：《中国介入影像与治疗学》2017年01期 　论文类型：期刊论文

【摘要】：目的观察TACE联合索拉非尼治疗不可切除肝细胞肝癌(HCC)的有效性和安全性。方法 36例诊断为不能手术切除HCC患者接受TACE联合索拉非尼治疗,每4周随访肝肾功能、甲胎蛋白水平,以mRECIST标准评价肿瘤疗效、记录不良反应发生情况。主要研究终点为联合治疗后总体生存时间(OS),次要研究终点包括联合治疗至疾病进展时间(TTP)、客观反应率(ORR)、疾病控制率(DCR)、安全性。结果本组联合治疗后中位OS 12.5个月,中位TTP 8个月。Child-Pugh分级A级的患者中位OS 15个月、B级的患者中位OS 10个月(2χ=0.07,P=0.05);肝脏单发病灶患者中位OS 18个月、多发病灶患者中位OS 10个月(2χ=4.16,P=0.04)。联合治疗后无完全缓解病例,部分缓解2例,疾病稳定10例,疾病进展24例,ORR 5.56%(2/36),DCR 33.33%(12/36)。主要不良反应为手足皮肤反应和腹泻。联合治疗前平均TACE次数3.3次,间隔时间平均45天,联合治疗后平均TACE次数2.1次,平均间隔120天。结论 TACE联合索拉非尼有助于延长晚期HCC的总体生存时间,尤其对于肝脏单发病灶及肝功能良好的患者。
[Abstract]:Objective to observe the efficacy and safety of TACE combined with sorafenil in the treatment of unresectable hepatocellular carcinoma (HCC). Methods 36 patients with HCC who were diagnosed as unresectable HCC were treated with TACE combined with Solafenil and were followed up every 4 weeks. The level of alpha-fetoprotein was evaluated by mRECIST standard. To record the occurrence of adverse reactions. The main endpoints of the study were the total survival time after combined therapy, and the secondary endpoints included TTP, objective response rate (ORR), disease control rate (DCR), and safety. Median OS was 12.5 months after combined therapy. Median TTP 8 months, Child-Pugh grade A, median OS 15 months, median OS 10 months, median OS 0.07, median OS 18 months, patients with multiple lesions, median OS 10 months, P 0.04. there was no complete remission after combined treatment. There were 2 cases of partial remission, 10 cases of stable disease and 24 cases of disease progression. The main adverse reactions were skin reaction and diarrhea. The average number of TACE before and after combined treatment was 3.3, the interval was 45 days, and the average number of TACE after combined therapy was 2.1. Conclusion TACE combined with Solafenib can prolong the overall survival time of advanced HCC, especially in patients with single liver lesions and good liver function.
【作者单位】：山东大学齐鲁医院放射科;
【分类号】：R735.7

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