论文部分内容阅读
目的 :评价肝动脉化疗栓塞术(TACE)联合索拉菲尼治疗中晚期原发性肝癌的临床疗效。方法 :将115例中晚期原发性肝癌患者(均为TNM分期)随机分为治疗组和对照组,治疗组58例,给予TACE术+索拉菲尼治疗,对照组57例,行TACE术治疗。观察两组患者的近期疗效、远期生存率及不良反应。结果:治疗结束后2个月治疗组的疾病控制率为74.1%,对照组为64.9%,两组比较无显著统计学差异(P=0.282)。治疗组的中位生存期为13.2个月,对照组的中位生存期为9.6个月,两组比较有显著统计学差异(P<0.001)。治疗组和对照组的1年生存率分别为62.5%和32.1%,两组比较有显著统计学差异(P=0.001)。两组的不良反应主要表现为胃肠道反应、骨髓抑制、皮肤黏膜反应及肝功能异常等。其中治疗组口腔黏膜炎及手足皮肤反应的发生率明显高于对照组,两组比较有显著统计学差异(P均<0.001,P<0.001)。结论:TACE联合索拉菲尼可提高中晚期原发性肝癌患者的1年生存率,且不良反应较小。
Objective: To evaluate the clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with sorafenib in the treatment of advanced primary liver cancer. Methods: One hundred and fifteen patients with advanced primary liver cancer (all TNM stage) were randomly divided into treatment group and control group. The treatment group (58 cases) received TACE + sorafenib treatment and the control group (57 cases) received TACE treatment. The short-term efficacy, long-term survival and adverse reactions of the two groups were observed. Results: The disease control rate was 74.1% in the treatment group and 64.9% in the control group 2 months after the end of treatment. There was no significant difference between the two groups (P = 0.282). The median survival time was 13.2 months in the treatment group and 9.6 months in the control group, with significant differences between the two groups (P <0.001). The 1-year survival rates of the treatment group and the control group were 62.5% and 32.1%, respectively, with significant difference between the two groups (P = 0.001). Adverse reactions in the two groups mainly manifested as gastrointestinal reactions, bone marrow suppression, skin and mucosal reactions and liver dysfunction. The incidence of oral mucositis and hand-foot skin reaction in the treatment group was significantly higher than that in the control group, with significant difference between the two groups (P <0.001, P <0.001). Conclusion: Combination of TACE and sorafenib can improve the 1-year survival rate of patients with primary hepatocellular carcinoma in the advanced stage, with less adverse reactions.