中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
13期
889-893
,共5页
罗小宁%陆骊工%邵培坚%胡宝山%李勇%禹娴怡%何旭
囉小寧%陸驪工%邵培堅%鬍寶山%李勇%禹嫻怡%何旭
라소저%륙려공%소배견%호보산%리용%우한이%하욱
癌,肝细胞%药疹%索拉非尼
癌,肝細胞%藥疹%索拉非尼
암,간세포%약진%색랍비니
Carcinoma,hepatocellular%Drug eruptions%Sorafenib
目的 探讨索拉非尼治疗中晚期肝癌相关的手足皮肤反应( HFRS)与疗效的关系.方法 分析广东省人民医院肿瘤介入科2008年5月至2011年6月51例索拉非尼联合经导管肝动脉化疗栓塞术(TACE)治疗的中晚期肝癌患者资料,比较HFRS 0级、1～2级、3级三组患者间的疾病控制率(DCR)、中位无疾病进展生存期(mPFS)、中位生存期(mOS)的差异,Cox模型分析影响PFS的因素.结果 13/51例未出现HFRS(即0级),38/51例出现HFRS,其中,1～2级27例,3级11例,三组DCR分别为38.5％、70.4％、90.9％,0级组比1～3级组的DCR:38.5％比76.3％,P=0.031,1～2级组比3级组,P=0.352；三组的mPFS分别为2.8(95％CI 1.6 ～4.0)、4.5(95％ CI 1.3 ～7.7)和12.8(95％ CI 3.7 ～21.9)个月,0级组比1～2级组,P=0.019,相关风险比(HR):2.8(95％CI 1.3～6.3),P=0.010,0级组比3级组,P＜0.01,HR:6.6(95％ CI2.3～19.0),P＜0.01,差异均有统计学意义,1～2级组比3级组,P=0.054;三组mOS分别为8.5(95％CI 5.9 ～ 11.1)、13.0(95％CI 10.1～15.9)和25.4个月,两两比较,P＜0.05.结论 HFRS可作为索拉非尼治疗中晚期肝癌临床疗效的预示指标,但是疗效是否随HFRS严重程度的递增而增加尚待论证.
目的 探討索拉非尼治療中晚期肝癌相關的手足皮膚反應( HFRS)與療效的關繫.方法 分析廣東省人民醫院腫瘤介入科2008年5月至2011年6月51例索拉非尼聯閤經導管肝動脈化療栓塞術(TACE)治療的中晚期肝癌患者資料,比較HFRS 0級、1～2級、3級三組患者間的疾病控製率(DCR)、中位無疾病進展生存期(mPFS)、中位生存期(mOS)的差異,Cox模型分析影響PFS的因素.結果 13/51例未齣現HFRS(即0級),38/51例齣現HFRS,其中,1～2級27例,3級11例,三組DCR分彆為38.5％、70.4％、90.9％,0級組比1～3級組的DCR:38.5％比76.3％,P=0.031,1～2級組比3級組,P=0.352；三組的mPFS分彆為2.8(95％CI 1.6 ～4.0)、4.5(95％ CI 1.3 ～7.7)和12.8(95％ CI 3.7 ～21.9)箇月,0級組比1～2級組,P=0.019,相關風險比(HR):2.8(95％CI 1.3～6.3),P=0.010,0級組比3級組,P＜0.01,HR:6.6(95％ CI2.3～19.0),P＜0.01,差異均有統計學意義,1～2級組比3級組,P=0.054;三組mOS分彆為8.5(95％CI 5.9 ～ 11.1)、13.0(95％CI 10.1～15.9)和25.4箇月,兩兩比較,P＜0.05.結論 HFRS可作為索拉非尼治療中晚期肝癌臨床療效的預示指標,但是療效是否隨HFRS嚴重程度的遞增而增加尚待論證.
목적 탐토색랍비니치료중만기간암상관적수족피부반응( HFRS)여료효적관계.방법 분석광동성인민의원종류개입과2008년5월지2011년6월51례색랍비니연합경도관간동맥화료전새술(TACE)치료적중만기간암환자자료,비교HFRS 0급、1～2급、3급삼조환자간적질병공제솔(DCR)、중위무질병진전생존기(mPFS)、중위생존기(mOS)적차이,Cox모형분석영향PFS적인소.결과 13/51례미출현HFRS(즉0급),38/51례출현HFRS,기중,1～2급27례,3급11례,삼조DCR분별위38.5％、70.4％、90.9％,0급조비1～3급조적DCR:38.5％비76.3％,P=0.031,1～2급조비3급조,P=0.352；삼조적mPFS분별위2.8(95％CI 1.6 ～4.0)、4.5(95％ CI 1.3 ～7.7)화12.8(95％ CI 3.7 ～21.9)개월,0급조비1～2급조,P=0.019,상관풍험비(HR):2.8(95％CI 1.3～6.3),P=0.010,0급조비3급조,P＜0.01,HR:6.6(95％ CI2.3～19.0),P＜0.01,차이균유통계학의의,1～2급조비3급조,P=0.054;삼조mOS분별위8.5(95％CI 5.9 ～ 11.1)、13.0(95％CI 10.1～15.9)화25.4개월,량량비교,P＜0.05.결론 HFRS가작위색랍비니치료중만기간암림상료효적예시지표,단시료효시부수HFRS엄중정도적체증이증가상대론증.
Objective To investigate the link between the antituinor efficacy of sorafenib and its cutaneous side effects in advanced hepatocellular carcinoma(HCC).Methods We retrospectively analyzed the incidence of hand-foot skin reactions (HFRS) of 51 patients with advanced HCC who treated by sorafenib combined with transcatheter arterial chemoembolization (TACE),comparing tumor disease control rate (DCR),median progression free survival (mPFS) and median overall survival(mOS) in the different severity HFRS groups.The Cox proportional hazard model was applied to the multivariate survival analysis for the PFS.Results Fifty-one HCC patients treated with sorafenib combined with TACE were included in this study.13/51 without HFRS( grade 0),38/51 developed at all grade 1 -3,27 developed at grade 1 -2,11 dcvcloped at grade 3.The DCR were 38.5％,70.4％ and 90.9％ in the three groups (P ＜0.05).Group grade 0 vs grade 1 -3,P=0.031,the difference had statistical significance.Group grade 1 -2 vs grade 3,P =0.352,the difference had no statistical significance.The mPFS were 2.8 months(95％ CI 1.6 -4.0 ),4.5 (95 ％ CI 1.3 - 7.7 ) months and 12.8 ( 95 ％ CI 3.7 - 21.9 ) months ( P ＜ 0.05 ),group grade 0 vs grade 1 - 2,P =0.019,HR ( hazard ratio):2.8 (95 ％ CI 1.3 - 6.3 ),P =0.010,group grade 0 vs grade 3,P ＜0.01,HR 6.6(95％ CI 2.3 - 19.0),P ＜0.01,group grade 1 -2 vs grade 3,P =0.054; the three groups' mOS were 8.5 months (95 ％ CI 5.9 - 11.1 ),13.0 (95％ CI 10.1 - 15.9 ) months and 25.4 months,P ＜0.05,there were statistically significant differences between the any two groups.Conclusions HFRS should be closely monitored in HCC patients treated with sorafenib in relation to its potential role as a surrogate narker of efficacy,but it has yet to be demonstrated whether the efficacy increasing with the severity of HFRS or not.
