CAJ | 학술논문

目的通过对经导管肝动脉化疗栓塞(TACE)联合索拉非尼治疗中晚期肝细胞癌患者的疾病进展时间(TTP)或总生存期(OS)的分析,观察介入栓塞与抗血管生成相结合治疗中晚期肝细胞癌的疗效;并分析治疗的安全性,为中晚期肝细胞癌的标准治疗模式提供证据来源.方法收集广东省人民医院肿瘤中心2007年4月至2010年1月经病理证实或临床确诊的符合标准的中晚期肝细胞癌患者36例,其中男33例、女3例;行TACE治疗后3～7 d内连续口服索拉非尼(商品名:多吉美)(每片200 mg),每次2片,每天2次.每4～8周为一个疗程,根据RECIST标准进行疗效评价,主要观察患者的肿瘤进展时间(TTP)及总生存期(OS),并记录不良事件.所有生存率采用寿命表法,所有生存率曲线均采用Kaplan-Meier法.结果随访至2010年3月,可评价的36例患者中,死亡14例,存活22例,中位肿瘤进展时间(mTTP)为8.62个月(95%CI:6.51～10.24个月),中位生存期(mOS)为12.41个月(95%CI:9.57～14.80个月).36例患者中,存活的22例,观察时间内的患者总体存活率为61.1%.存活病例中,没有CR病例,1例PR,15例SD,6例PD;疾病控制率(DCR)(CR+PR+SD)为44.4%.服用索拉非尼主要不良反应为手足皮肤反应、腹泻、乏力及食欲下降,经对症处理后绝大多数可以明显缓解.结论 TACE联合索拉非尼治疗中晚期肝细胞癌患者有可能获得较长的生存时间和疾病稳定状态,进一步丰富了中晚期肝细胞癌的治疗模式.口服索拉非尼的不良反应可以耐受.
목적 통과대경도관간동맥화료전새(TACE)연합색랍비니치료중만기간세포암환자적질병진전시간(TTP)혹총생존기(OS)적분석,관찰개입전새여항혈관생성상결합치료중만기간세포암적료효;병분석치료적안전성,위중만기간세포암적표준치료모식제공증거래원.방법 수집광동성인민의원종류중심2007년4월지2010년1월경병리증실혹림상학진적부합표준적중만기간세포암환자36례,기중남33례、녀3례;행TACE치료후3～7 d내련속구복색랍비니(상품명:다길미)(매편200 mg),매차2편,매천2차.매4～8주위일개료정,근거RECIST표준진행료효평개,주요관찰환자적종류진전시간(TTP)급총생존기(OS),병기록불량사건.소유생존솔채용수명표법,소유생존솔곡선균채용Kaplan-Meier법.결과 수방지2010년3월,가평개적36례환자중,사망14례,존활22례,중위종류진전시간(mTTP)위8.62개월(95%CI:6.51～10.24개월),중위생존기(mOS)위12.41개월(95%CI:9.57～14.80개월).36례환자중,존활적22례,관찰시간내적환자총체존활솔위61.1%.존활병례중,몰유CR병례,1례PR,15례SD,6례PD;질병공제솔(DCR)(CR+PR+SD)위44.4%.복용색랍비니주요불량반응위수족피부반응、복사、핍력급식욕하강,경대증처리후절대다수가이명현완해.결론 TACE연합색랍비니치료중만기간세포암환자유가능획득교장적생존시간화질병은정상태,진일보봉부료중만기간세포암적치료모식.구복색랍비니적불량반응가이내수.
Objective To provide more evidence sources to the standard treatment for patients with advanced hepatocellular carcinoma,the writer analyze patients' time to progression (TTP) and overall survival (OS) after patients receiving transcatheter arterial chemoembolization (TACE) combined with sorafenib as a treatment of advanced hepatocellular carcinoma (HCC);observe the healing effect embolization combined with anti-angiogenic treatment for advanced hepatocellular carcinoma;and also analyze treatment of security.MethodsThere are 36 patients,33 male and 3 female had been Pathologically or clinical diagnosis.After receiving Transcatheter Arterial Chemoembolization (TACE)therapy,in the following 3 to 7 days,this group of patients continuously take sorafenib ( brand name:Nexavar) ( per tablet 200 mg),2 tablets each time,2 times a day.Every 4 to 8 weeks is called as one period of treatment.Referring to RECIST Evaluation,the writers mainly observe patients' tumor progression (TTP) and overall survival (OS),record adverse events.Using life table method to analyze survival rate,using Kaplan-Meier method to analyze all the survival curves.Results Till March,2010,14 of 36evaluable patients died and 22 survive;the median time to tumor progression (mTTP) to 8.62 months (95%CI:6.51-10.24 months);the median survival time (mOS) of 12.41 months (95% CI:9.57-14.80months).The overall survival rate to observation period is 61.1%;36 patients had been studied,22survive.Among the survivals,there is no CR cases,and 1 case PR,15 patients SD,6 patients PD;disease control rate (DCR) (CR + PR + SD) is 44.4%.The side effects of taking Sorafenib mainly are hand-foot skin reaction,diarrhea,fatigue and loss of appetite.These side effects can be markedly eased after symptomatic treatment.Conclusion Combined with sorafenib treatment may give patients with advanced hepatocellular carcinoma a longer longevity and keep the disease in a steady state.This therapy can be added into the treatments to patients with advanced hepatocellular carcinoma.The side effects of taking Sorafenib (Nexavar) could be stand.