索拉菲尼对行肝动脉化疗栓塞术治疗的BCLCB/C期肝细胞癌患者的疗效
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摘要
目的:研究索拉菲尼对接受动脉化疗栓塞术(TACE)治疗的巴塞罗那分期(BCLC)B/C期肝细胞癌患者疗效的增益作用。方法:选取2013年1月至2017年12月在丽水市中心医院行TACE治疗的BCLC B/C期肝细胞癌患者84例,所有患者均经穿刺活检证实为肝细胞癌。根据有无服用索拉菲尼分为TACE组(45例)和索拉菲尼联合TACE组(联合组,39例),所有入组患者定期随访监测3年,并记录临床资料,比较2组患者之间的疾病控制及生存获益情况,明确索拉菲尼对TACE的增益作用。结果:联合组的肿瘤反应(为64.1%)明显优于TACE组(为37.21%()P=0.008);TACE组患者的6个月、1年、2年和3年生存率分别为60%、40%、13.3%和8.9%,联合组为82.1%、51.3%、30.8%和16.9%;TACE组和联合组的总生存时间分别为12.9个月和19.3个月,无进展生存时间分别为6.0个月和16.2个月,联合组的总生存时间(P=0.032)和无进展生存时间(P=0.006)均显著优于TACE组。结论:针对行TACE治疗的BCLC B/C期肝细胞癌患者,索拉菲尼能够使患者的整体生存期显著获益,提高肝癌TACE的治疗效果。
Objective: To explore the synergistic effect of the sorafenib on the efficacy of BCLC B/C hepatocellular carcinoma(HCC) patients treated with transcatheter arterial chemoembolization(TACE). Methods:Eighty-four patients with BCLC stage B/C hepatocellular carcinoma who were treated with TACE in our hospital from January 2013 to December 2017 were retrospectively selected. All patients were confirmed as hepatocellular carcinoma by biopsy, and further divided into TACE group(45 patients) and the sorafenib combined with TACE group(combination group, 39 patients) according to the presence or absence of sorafenib. All enrolled patients were followed up for three years, and clinical data were recorded. The disease control and survival benefits between the two groups were compared, and the synergistic effect of sorafenib on TACE was determined.Results: The tumor response of the combination group(64.1%) was significantly better than that of the TACE group(37.21%)(P=0.008). The 6-month, 1-year, 2-year and 3-year survival rates of patients in the TACE group were 60%, 40%, 13.3% and 8.9%, respectively, and those in the combination group were 82.1%, 51.3%, 30.8%and 16.9%. The overall survival time of the TACE group and the combination group was 12.9 months and 19.3 months, respectively; the progression-free survival time was 6.044 months and 16.218 months, respectively. The overall survival time(P=0.032) and progression-free survival time(P=0.006) of the combination group were significantly better than that of TACE group. Conclusion: For BCLC B/C stage HCC patients treated with TACE,sorafenib could significantly benefit the overall survival of patients and improve the TACE efficacy of HCC.
Objective: To explore the synergistic effect of the sorafenib on the efficacy of BCLC B/C hepatocellular carcinoma(HCC) patients treated with transcatheter arterial chemoembolization(TACE). Methods:Eighty-four patients with BCLC stage B/C hepatocellular carcinoma who were treated with TACE in our hospital from January 2013 to December 2017 were retrospectively selected. All patients were confirmed as hepatocellular carcinoma by biopsy, and further divided into TACE group(45 patients) and the sorafenib combined with TACE group(combination group, 39 patients) according to the presence or absence of sorafenib. All enrolled patients were followed up for three years, and clinical data were recorded. The disease control and survival benefits between the two groups were compared, and the synergistic effect of sorafenib on TACE was determined.Results: The tumor response of the combination group(64.1%) was significantly better than that of the TACE group(37.21%)(P=0.008). The 6-month, 1-year, 2-year and 3-year survival rates of patients in the TACE group were 60%, 40%, 13.3% and 8.9%, respectively, and those in the combination group were 82.1%, 51.3%, 30.8%and 16.9%. The overall survival time of the TACE group and the combination group was 12.9 months and 19.3 months, respectively; the progression-free survival time was 6.044 months and 16.218 months, respectively. The overall survival time(P=0.032) and progression-free survival time(P=0.006) of the combination group were significantly better than that of TACE group. Conclusion: For BCLC B/C stage HCC patients treated with TACE,sorafenib could significantly benefit the overall survival of patients and improve the TACE efficacy of HCC.
引文
[1]SIA D,VILLANUEVA A,FRIEDMAN S L,et al.Liver cancer cell of origin,molecular class,and effects on patient prognosis[J].Gastroenterology,2017,152(4):745-761.
[2]JEMAL A,BRAY F,CENTER M M,et al.Global cancer statistics[J].CA Cancer J Clin,2011,61(2):69-90.
[3]POKURI V K,TOMASZEWSKI G M,AIT-OUDHIA S,et al.Efficacy,safety,and potential biomarkers of sunitinib and transarterial chemoembolization(TACE)combination in advanced hepatocellular carcinoma(HCC):Phase II trial[J].Am J Clin Oncol,2018,41(4):332-338.
[4]GALLE P R,FORNER A,LLOVET J M,et al.EASL clinical practice guidelines:management of hepatocellular carcinoma[J].J Hepatol,2018,69(1):182-236.
[5]SIEGHART W,HUCKE F,PECK-RADOSAVLJEVIC M.Transarterial chemoembolization:modalities,indication,and patient selection[J].J Hepatol,2015,62(5):1187-1195.
[6]YANG J D,AQEL B A,PUNGPAPONG S,et al.Direct acting antiviral therapy and tumor recurrence after liver transplantation for hepatitis C-associated hepatocellular carcinoma[J].J Hepatol,2016,65(4):859-860.
[7]吴发宗,吕秀玲,宋晶晶,等.阿帕替尼联合肝动脉化疗栓塞术的抗肝癌疗效及对肿瘤血管再生的影响[J].温州医科大学学报,2019,49(6):423-426.
[8]赵鹏,陈东,陈伟,等.索拉菲尼治疗晚期原发性肝细胞癌的疗效及其预测因素[J].中华外科杂志,2012,50(6):514-517.
[9]张惠洁,郭卫东.索拉菲尼在肿瘤治疗中的研究进展[J].中华临床医师杂志(电子版),2013,7(1):137-139.
[10]丁文金,李飞平,龚光文,等.TACE联合索拉菲尼与TACE治疗巴塞罗那B期肝癌的临床对比研究[J].肿瘤药学,2015(3):230-234.
[11]杨明,罗克品,谢岳云,等.肝动脉化疗栓塞联合索拉菲尼治疗中晚期肝细胞癌[J].肝胆胰外科杂志,2013,25(4):265-268.
[12]付元,纪建松,涂建飞,等.TACE联合RFA及索拉菲尼在肝癌外科术后复发治疗中的临床应用[J].介入放射学杂志,2015,24(12):1067-1071.
[2]JEMAL A,BRAY F,CENTER M M,et al.Global cancer statistics[J].CA Cancer J Clin,2011,61(2):69-90.
[3]POKURI V K,TOMASZEWSKI G M,AIT-OUDHIA S,et al.Efficacy,safety,and potential biomarkers of sunitinib and transarterial chemoembolization(TACE)combination in advanced hepatocellular carcinoma(HCC):Phase II trial[J].Am J Clin Oncol,2018,41(4):332-338.
[4]GALLE P R,FORNER A,LLOVET J M,et al.EASL clinical practice guidelines:management of hepatocellular carcinoma[J].J Hepatol,2018,69(1):182-236.
[5]SIEGHART W,HUCKE F,PECK-RADOSAVLJEVIC M.Transarterial chemoembolization:modalities,indication,and patient selection[J].J Hepatol,2015,62(5):1187-1195.
[6]YANG J D,AQEL B A,PUNGPAPONG S,et al.Direct acting antiviral therapy and tumor recurrence after liver transplantation for hepatitis C-associated hepatocellular carcinoma[J].J Hepatol,2016,65(4):859-860.
[7]吴发宗,吕秀玲,宋晶晶,等.阿帕替尼联合肝动脉化疗栓塞术的抗肝癌疗效及对肿瘤血管再生的影响[J].温州医科大学学报,2019,49(6):423-426.
[8]赵鹏,陈东,陈伟,等.索拉菲尼治疗晚期原发性肝细胞癌的疗效及其预测因素[J].中华外科杂志,2012,50(6):514-517.
[9]张惠洁,郭卫东.索拉菲尼在肿瘤治疗中的研究进展[J].中华临床医师杂志(电子版),2013,7(1):137-139.
[10]丁文金,李飞平,龚光文,等.TACE联合索拉菲尼与TACE治疗巴塞罗那B期肝癌的临床对比研究[J].肿瘤药学,2015(3):230-234.
[11]杨明,罗克品,谢岳云,等.肝动脉化疗栓塞联合索拉菲尼治疗中晚期肝细胞癌[J].肝胆胰外科杂志,2013,25(4):265-268.
[12]付元,纪建松,涂建飞,等.TACE联合RFA及索拉菲尼在肝癌外科术后复发治疗中的临床应用[J].介入放射学杂志,2015,24(12):1067-1071.