索拉非尼治疗中晚期肝癌预后因素分析

发布时间：2018-03-19 21:34

本文选题：肝细胞肝癌　切入点：分子靶向治疗　出处：《介入放射学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的探索索拉非尼治疗中晚期肝癌患者的预后影响因素。方法回顾性分析2010年2月至2015年6月经病理证实或临床影像诊断,并符合巴塞罗那肝癌分期(BCLC)标准的中晚期肝细胞癌患者38例,口服索拉非尼,400 mg/次,2次/d,每4~6周根据mRECIST标准进行肿瘤应答的评价,并记录不良反应的发生情况,按美国国立癌症研究所常见不良反应分级标准3.0版评估药物毒性。结果 38例患者中1例服药2周后发生肝性脑病停药,37例患者中14例患者出现不同程度胰腺萎缩(阳性组),中位无疾病进展时间(mPFS)9.0个月,中位总生存时间(mOS)25.8个月;23例患者未出现胰腺萎缩(阴性组),中位无疾病进展时间(mPFS)3.3个月,中位总生存时间(mOS)8.4个月,两组mOS比较P0.001,两组mPFS比较P=0.025,均有统计学意义。主要不良反应为手足皮肤反应、腹泻、乏力、体重下降,均经对症处理后缓解,无严重不良反应发生。结论索拉非尼的疗效与胰腺萎缩呈一定相关性,出现严重腹泻并发胰腺萎缩的患者可获得较长的生存时间和疾病稳定状态。
[Abstract]:Objective to explore the prognostic factors of patients with advanced liver cancer treated with Solafenib. Methods from February 2010 to 2015, the pathological confirmation or clinical imaging diagnosis were retrospectively analyzed. 38 patients with advanced hepatocellular carcinoma (HCC) according to Barcelona liver cancer staging criteria were treated with oral sorafenil 400 mg/ twice a day. The tumor response was evaluated according to the mRECIST criteria every 4 weeks and the adverse reactions were recorded. The toxicity of the drug was evaluated according to the National Cancer Institute Common adverse reaction rating Standard version 3.0. Results 1 of 38 patients developed hepatic encephalopathy after 2 weeks of medication and 14 of 37 patients developed pancreatic wilting in varying degrees. In positive group, the median time of disease progression was 9.0 months. The median total survival time was 25.8 months and 23 patients did not develop pancreatic atrophy (negative group, median no disease progression time 3.3 months, median total survival time 8.4 months). There were significant differences in mOS between two groups (P 0.001) and mPFS in two groups (P 0.025). The main adverse reactions were skin reaction of hand and foot, diarrhea, fatigue, weight loss, which were relieved after symptomatic treatment. Conclusion the curative effect of Solafenib is correlated with pancreatic atrophy. Patients with severe diarrhea complicated with pancreatic atrophy can obtain longer survival time and stable state of disease.
【作者单位】：解放军总医院介入放射科;
【分类号】：R735.7

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