CAJ | 학술논문

目的：评价经导管肝动脉化疗栓塞术（ TACE）联合索拉非尼治疗肝细胞肝癌的疗效和安全性。方法入选57例原发性肝细胞肝癌患者，其中23例行TACE联合索拉菲尼治疗（试验组），34例行单纯TACE治疗（对照组），对照组用阿霉素类药物20～40 mg化疗，超液化碘油剂量5～20 mL。如果患者需要进行多次TACE治疗，每次TACE治疗的时间间隔约为45 d。试验组在对照组基础上，第1次TACE治疗后72 h内口服索拉非尼400 mg，早、晚各服1次，连续服药，直至药品不良反应不能耐受或疾病进展。比较2组疗效、生存状况和不良反应。结果试验组近期疗效优于对照组（ P＜0.05）。试验组中位生存期为14.9个月，高于对照组的8.7个月（ P＞0.05）。试验组患者腹泻、手足综合征、皮疹的发生率均高于对照组（ P＜0.05）；2组患者消化道反应、骨髓抑制、肝功能异常的发生率差异均无统汁学意义（ P＞0.05）。结论 TACE联合索拉非尼治疗肝细胞肝癌能延长患者生存期，且安全性与耐受性较好。
목적：평개경도관간동맥화료전새술（ TACE）연합색랍비니치료간세포간암적료효화안전성。방법입선57례원발성간세포간암환자，기중23례행TACE연합색랍비니치료（시험조），34례행단순TACE치료（대조조），대조조용아매소류약물20～40 mg화료，초액화전유제량5～20 mL。여과환자수요진행다차TACE치료，매차TACE치료적시간간격약위45 d。시험조재대조조기출상，제1차TACE치료후72 h내구복색랍비니400 mg，조、만각복1차，련속복약，직지약품불량반응불능내수혹질병진전。비교2조료효、생존상황화불량반응。결과시험조근기료효우우대조조（ P＜0.05）。시험조중위생존기위14.9개월，고우대조조적8.7개월（ P＞0.05）。시험조환자복사、수족종합정、피진적발생솔균고우대조조（ P＜0.05）；2조환자소화도반응、골수억제、간공능이상적발생솔차이균무통즙학의의（ P＞0.05）。결론 TACE연합색랍비니치료간세포간암능연장환자생존기，차안전성여내수성교호。
Objective To evaluate the efficacy and safety of transarterial chemoembolization ( TACE ) combined with sorafenib in patients with hepatocellular carcinoma.Methods A total of 57 patients with hepato-cellular carcinoma were divided into control group ( n =34 ) and treat-ment group ( n=23 ).Patients in the treatment group were treated with TACE ( doxorubicin 20-40 mg and lipiodol 5-20 mL) combined with oral sorafenib 400 mg within the 72 h after the first TACE, bid.And the sorafenib treatment would be continued until drug adverse reactions were not tolerated or progression disease occurred.Those in control group only received TACE treatment.If patients needed multiple TACE treatment, the time interval was about 45 d.The data of clinical efficacy, survival condition and drug adverse reactions were compared between two groups.Results The short time efficacy in the treatment group was better than the control group(P<0.05).The median survival time was 14.9 months in treatment group, significantly higher than 8.7 months in the control group ( P<0.05).The incidence rates of diarrhea, hand -foot syndrome and rash in the treatment group were higher than those in the control group ( P<0.05 ).There was no significant difference between the two groups in the incidence rate of gastrointestinal reactions , myelosuppression and liver dysfunction ( P>0.05 ).Conclusion The combination of TACE and sorafenib can prolong survival time of patients with hepatocellular carcinoma, which is safe and well tolerated.