CAJ | 학술논문

目的探讨经导管肝动脉化疗栓塞（TACE）联合索拉非尼治疗肝转移癌的疗效和安全性。方法对2007年3月至2009年4月，78例肝转移癌患者的临床资料进行分析，其中男性46例，女性32例，年龄33～79岁，平均（58±6）岁；肿瘤直径3.6～13.5 cm ，平均（6±3）cm。其中单发转移癌17例，多发转移癌61例。患者均为全身化疗失败或无法耐受，且无其他脏器转移者。对比TACE术后口服索拉非尼的39例肝转移癌患者（联合组）和另同期行TACE的39例肝转移癌患者（对照组）的疗效。每6～8周复查1次，评价肝功能，治疗效果及CT、数字减影血管造影（DSA）和不良反应。用SPSS 13.0软件统计计算中位生存时间，平均生存时间和疾病进展时间。结果随访至2011年5月，联合组21例患者存活（54％），18例（含失访）死亡（46％）；对照组12例存活（31％），27例（含失访）死亡（69％）；至观察终点，2组均没有完全缓解病例。6、12、24个月生存率治疗组为92％（35/39），74％（29/39），49％（19/39）；对照组为82％（32/39），64％（25/39），36％（14/39）；差异有统计学意义。联合组不良反应主要表现为食欲下降、发热、乏力、皮肤反应等；对照组不良反应为恶心、呕吐、发热、疼痛等。2组不良反应经对症处理后均能够缓解。结论索拉非尼联合TACE治疗肝转移癌较单用 TACE治疗能延长患者生存期，无严重不良反应的发生。
목적탐토경도관간동맥화료전새（TACE）연합색랍비니치료간전이암적료효화안전성。방법대2007년3월지2009년4월，78례간전이암환자적림상자료진행분석，기중남성46례，녀성32례，년령33～79세，평균（58±6）세；종류직경3.6～13.5 cm ，평균（6±3）cm。기중단발전이암17례，다발전이암61례。환자균위전신화료실패혹무법내수，차무기타장기전이자。대비TACE술후구복색랍비니적39례간전이암환자（연합조）화령동기행TACE적39례간전이암환자（대조조）적료효。매6～8주복사1차，평개간공능，치료효과급CT、수자감영혈관조영（DSA）화불량반응。용SPSS 13.0연건통계계산중위생존시간，평균생존시간화질병진전시간。결과수방지2011년5월，연합조21례환자존활（54％），18례（함실방）사망（46％）；대조조12례존활（31％），27례（함실방）사망（69％）；지관찰종점，2조균몰유완전완해병례。6、12、24개월생존솔치료조위92％（35/39），74％（29/39），49％（19/39）；대조조위82％（32/39），64％（25/39），36％（14/39）；차이유통계학의의。연합조불량반응주요표현위식욕하강、발열、핍력、피부반응등；대조조불량반응위악심、구토、발열、동통등。2조불량반응경대증처리후균능구완해。결론색랍비니연합TACE치료간전이암교단용 TACE치료능연장환자생존기，무엄중불량반응적발생。
Objective To evaluate the clinical effects and safety of sorafenib combined with TACE in treat-ment for liver metastatic carcinoma .Methods From March 2007 to April 2009 ,data of 78 cases of liver metastat-ic carcinoma patients was analysed including 46 male cases and 32 female cases whose ages were range from 33 years to 79 years ,the average age of them are 58 ± 6 .Their tumour diameter is 3 .6~13 .5 cm with an average of (6 ± 3)cm .There are 17 cases solitary carcinoma and 61 cases multiple metastatic carcinoma .All the patients are systemic chemotherapy failure or unable to withstand ,and without any other organ metastasis .Thirty-nine cases metastatic carcinoma patients are in treatment group who take sorafenib orally after TACE operation ,meanwhile , the other 39 cases of control group are under TACE operation .The curative effects of these two group were then compared .To reexamine every 6-8 weeks ,then to evaluate their liver function ,therapeutic effect ,CT DSA radio-graphy and untoward effect .SPSS 13 .0 was used to calculate the meso-position survival time ,average survival time and progressive disease time statistically .Results A follow-up visit was made until May 2011 .In treatment group ,21 cases patients were survived with the rate of 54% and 18 cases were died with a rate of 46% .In control group 12 cases patients were survival with a rate of 32% and 27 cases are died with a rate of 69% .There is no case for complete remission in the two group even at the end .In treatment group ,the survival rate for 6 months ,12 months ,24 months is 92% (35/39) ,74% (29/39) ,49% (19/39) ,respectively .In control group ,the rate of them is 82% (32/39) ,64% (25/39) ,34% (14/39) ,respectively and their differences have statistical signifi-cance .The untoward effects of control group were decreased appetite ,fever ,weakness and skin reaction etc ;while the control group were nausea ,vomiting ,fever and ache etc .The untoward effects of the two groups could be remitted by symptomatic treatment .Conclusion Comparing with using TACE alone ,sorafenib combined with TACE can extend the life cycle of patients without any untoward effects .