CAJ | 학술논문

目的观察超米兰标准肝癌患者肝移植术后应用索拉非尼防治肿瘤复发的疗效.方法将2008年3月至2010年6月在我院行肝移植手术的超米兰标准肝癌患者30例分为两组,每组各15例.实验组:口服索拉非尼400 mg每日2次.对照组:口服卡培他滨1500 mg每日2次,每个疗程服用14 d后休息2周.两组中术后18个月未复发者均停止用药.治疗过程中出现复发者则维持原剂量直至患者不宜再继续服药.出现严重不良反应者减量或停药.结果实验组1年复发率为53.3％,对照组86.6％,两组比较差异有统计学意义(x2=3.968,P＜0.05).实验组1年生存率为93.3％,对照组46.6％,两组比较差异有统计学意义(x2=7.777,P＜0.05).实验组患者生存期7～36个月,平均(28.3±2.5)个月,对照组生存期5～41个月,平均(17.9±3.5)个月.实验组患者生存时间显著长于对照组(x2=5.702,P＜0.05).实验组及对照组的毒副反应大部分为Ⅰ、Ⅱ度,其中实验组发生腹泻、手足综合征的概率较对照组高.结论超米兰标准的肝癌患者肝移植术后预防应用索拉非尼可以推迟肝癌的复发,延长患者的生存期,药物的毒副作用患者可以耐受.
목적 관찰초미란표준간암환자간이식술후응용색랍비니방치종류복발적료효.방법 장2008년3월지2010년6월재아원행간이식수술적초미란표준간암환자30례분위량조,매조각15례.실험조:구복색랍비니400 mg매일2차.대조조:구복잡배타빈1500 mg매일2차,매개료정복용14 d후휴식2주.량조중술후18개월미복발자균정지용약.치료과정중출현복발자칙유지원제량직지환자불의재계속복약.출현엄중불량반응자감량혹정약.결과 실험조1년복발솔위53.3％,대조조86.6％,량조비교차이유통계학의의(x2=3.968,P＜0.05).실험조1년생존솔위93.3％,대조조46.6％,량조비교차이유통계학의의(x2=7.777,P＜0.05).실험조환자생존기7～36개월,평균(28.3±2.5)개월,대조조생존기5～41개월,평균(17.9±3.5)개월.실험조환자생존시간현저장우대조조(x2=5.702,P＜0.05).실험조급대조조적독부반응대부분위Ⅰ、Ⅱ도,기중실험조발생복사、수족종합정적개솔교대조조고.결론 초미란표준적간암환자간이식술후예방응용색랍비니가이추지간암적복발,연장환자적생존기,약물적독부작용환자가이내수.
Objective To observe the efficacy of using sorafenib in preventing and treating tumor recurrence after liver transplantation for patients with primary hepatic carcinoma exceeding Milan criteria.Methods From March 2008 to June 2010,30 patients of liver transplantation with primary hepatic carcinoma exceeding Milan criteria were randomized into 2 groups,each group of 15 cases.The experimental group received oral administration of sorafenib (400 mg bid) ; the control group received capecitabine (1500 mg bid) for 14 days every 4 weeks.The patient without recurrence in 18 months after transplantation stoped taking the medication.The recurrent patients maintained the original dose until they were not suitable for the medication.Patients with serious adverse reactions must reduce the dose or stop the medication.Results The 1 year recurrence rate of experimental group was 53.3％,the control group was 86.6％,the difference between 2 groups was statistically significant (x2 =3.968,P＜0.05).The 1 year survival rate of experimental group was 93.3％,the control group was 46.6％,the difference between 2 groups was statistically significant (x2 =7.777,P＜0.05).The mean survival time of experimental group was (28.3±2.5)months (7～36 months),the control group was (17.9±3.5)months (5 ～ 41 months),the experimental group patients' survival time was longer than the control group,the differences was statistically significant (x2=5.702,P＜0.05 ).Most adverse reactions in 2 groups were grade Ⅰ - Ⅱ.The incidence of diarrhea and hand-foot syndrome in experimental group was higher than in control group.Conclusion Using sorafenib for patients with primary hepatic carcinoma exceeding Milan criteria after liver transplantation probably may reduce or delay the process of carcinoma recurrence,can prolong the survival time of those patients,and side effects can be tolerated.