中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2014年
11期
781-785
,共5页
郑鹏飞%刘宏宇%叶研硕%李卓男%李巍
鄭鵬飛%劉宏宇%葉研碩%李卓男%李巍
정붕비%류굉우%협연석%리탁남%리외
肝细胞肝癌%经肝动脉化疗栓塞%肝切除术%索拉非尼%术后复发
肝細胞肝癌%經肝動脈化療栓塞%肝切除術%索拉非尼%術後複髮
간세포간암%경간동맥화료전새%간절제술%색랍비니%술후복발
Hepatocellular carcinoma%Transarterial chemoembolization%Liver resection%Sorafenib%Recurrence
目的 对几种治疗中晚期肝癌(HCC)的方法进行比较,以期指导今后临床工作.方法 回顾我院近7年126例中晚期肝癌患者随访资料.患者按治疗方法分为六组:未治疗组、TACE组、手术组、TACE+索拉非尼组、手术+TACE组、手术+TACE+索拉非尼组.应用Kaplan-Meier生存曲线进行生存分析,应用log-rank检验各组结果.结果 对非手术患者,TACE+索拉非尼治疗组1年生存率和中位生存期分别为62.5％和16个月,优于未治疗组和单纯TACE组.手术治疗组1年及总生存期明显优于非手术各组.单纯手术组、手术+TACE组、手术+TACE+索拉非尼组1年和2年生存率分别为87％、95％、88.9％和52.2％、50.0％、55.6％,三组间比较差异无统计学意义;但3年生存率手术+ TACE+索拉非尼组明显高于单纯手术组和手术+TACE组.三组的中位生存期分别为24、24.5和28个月.三组术后复发后中位生存期分别为7、9.5、和18个月,索拉非尼治疗可显著延长术后复发患者的总体生存时间.结论 中晚期HCC治疗效果仍以手术最好,应首选.对于不能手术切除的HCC患者,TACE联和索拉非尼治疗是较好的选择.索拉非尼能有效控制HCC术后复发的进展,显著延长患者带瘤生存时间,可能是预防和治疗HCC术后复发的最佳措施.
目的 對幾種治療中晚期肝癌(HCC)的方法進行比較,以期指導今後臨床工作.方法 迴顧我院近7年126例中晚期肝癌患者隨訪資料.患者按治療方法分為六組:未治療組、TACE組、手術組、TACE+索拉非尼組、手術+TACE組、手術+TACE+索拉非尼組.應用Kaplan-Meier生存麯線進行生存分析,應用log-rank檢驗各組結果.結果 對非手術患者,TACE+索拉非尼治療組1年生存率和中位生存期分彆為62.5％和16箇月,優于未治療組和單純TACE組.手術治療組1年及總生存期明顯優于非手術各組.單純手術組、手術+TACE組、手術+TACE+索拉非尼組1年和2年生存率分彆為87％、95％、88.9％和52.2％、50.0％、55.6％,三組間比較差異無統計學意義;但3年生存率手術+ TACE+索拉非尼組明顯高于單純手術組和手術+TACE組.三組的中位生存期分彆為24、24.5和28箇月.三組術後複髮後中位生存期分彆為7、9.5、和18箇月,索拉非尼治療可顯著延長術後複髮患者的總體生存時間.結論 中晚期HCC治療效果仍以手術最好,應首選.對于不能手術切除的HCC患者,TACE聯和索拉非尼治療是較好的選擇.索拉非尼能有效控製HCC術後複髮的進展,顯著延長患者帶瘤生存時間,可能是預防和治療HCC術後複髮的最佳措施.
목적 대궤충치료중만기간암(HCC)적방법진행비교,이기지도금후림상공작.방법 회고아원근7년126례중만기간암환자수방자료.환자안치료방법분위륙조:미치료조、TACE조、수술조、TACE+색랍비니조、수술+TACE조、수술+TACE+색랍비니조.응용Kaplan-Meier생존곡선진행생존분석,응용log-rank검험각조결과.결과 대비수술환자,TACE+색랍비니치료조1년생존솔화중위생존기분별위62.5％화16개월,우우미치료조화단순TACE조.수술치료조1년급총생존기명현우우비수술각조.단순수술조、수술+TACE조、수술+TACE+색랍비니조1년화2년생존솔분별위87％、95％、88.9％화52.2％、50.0％、55.6％,삼조간비교차이무통계학의의;단3년생존솔수술+ TACE+색랍비니조명현고우단순수술조화수술+TACE조.삼조적중위생존기분별위24、24.5화28개월.삼조술후복발후중위생존기분별위7、9.5、화18개월,색랍비니치료가현저연장술후복발환자적총체생존시간.결론 중만기HCC치료효과잉이수술최호,응수선.대우불능수술절제적HCC환자,TACE련화색랍비니치료시교호적선택.색랍비니능유효공제HCC술후복발적진전,현저연장환자대류생존시간,가능시예방화치료HCC술후복발적최가조시.
Objective To analyze the outcomes of different treatments in 126 patients with advanced hepatocellular carcinoma (HCC).Methods The follow-up data of 126 BCLC-B or C stage HCC patients who received different treatments were retrospectively studied.These patients were divided into six groups according to the treatment.Group 1:untreated; Group 2:TACE only; Group 3:TACE + Sorafenib;Group 4:liver resection ; Group 5:liver resection + TACE; Group 6:liver resection + TACE + Sorafenib.The survival times were analyzed using Kaplan-Meier method and the results were analyzed using the log-rank test.Results Among the non-surgery groups,the 1 year survival rate in Group 3 (62.5％,medium survival 16 months) was longer than Groups 1 and 2.For patients in the liver resection groups,the 1 year and overall survival rates were much better than the non-surgery groups.There were no significant differences in 1 year and 2 year survivals among Groups 4,5,and 6.However,the 3 year survival rate in Group 6 was much longer than Groups 4 and 5.The medium survival in Groups 4,5,and 6 were 24,24.5,and 28 months,respectively.Moreover,the medium survivals after post-hepatectomy recurrence in Groups 4,5 and 6 were 7,9.5,and 18 months,respectively.Sorafenib significantly prolonged survival after HCC recurrence.Conclusions Liver resection was still the best and the most effective treatment for patients with advanced HCC.Combining TACE with Sorafenib was a better treatment for patients with non-resectable HCC.Sorafenib effectively inhibited progression of post-hepatectomy HCC recurrence and significantly prolonged survival.Therefore,Sorafenib is a good approach in the prevention and treatment of HCC recurrence.
