摘要
目的观察中晚期肝癌不同血清甲胎蛋白(AFP)亚组应用索拉非尼(多吉美)联合经导管肝动脉化疗栓塞术(TACE)治疗的疗效。方法收集2009年4月至2011年10月经病理证实或临床影像诊断,并符合巴塞罗那肝癌分期(Barcelona Clinic Liver Cancer,BCLC)标准的中晚期肝细胞癌患者148例,根据AFP水平分为4个亚组:亚组Ⅰ0～20μg/L;亚组Ⅱ20～400μg/L;亚组Ⅲ400～20000μg/L;亚组Ⅳ>20000μg/L。口服索拉非尼,400mg/次,2次/d,每4～6周根据RECIST标准进行肿瘤应答的评价,并记录不良反应的发生情况,按NCI-CTC(3.0版)评价中位肿瘤进展情况和药物毒性。结果 148例患者中,亚组Ⅰ(B期22例,C期32例):稳定(SD)39例、疾病进展(PD)11例、部分缓解(PR)3例、完全缓解(CR)1例(肝内病灶消失),疾病控制率(DCR)79%,中位肿瘤进展时间(mTTP)为6个月;亚组Ⅱ(B期13例,C期24例):SD22例、PD15例、PR0例、CR0例,DCR59%,mTTP为4个月;亚组Ⅲ(B期14例,C期29例):SD27例、PD16例、PR0例、CR0例,DCR62%,mTTP为4个月;亚组Ⅳ(B期4例,C期10例):SD7例、PD7例、PR0例、CR0例,DCR50%,mTTP为3个月。148例患者总疾病控制率为66%,主要不良反应为手足皮肤反应、腹泻、皮疹、脱发。所有患者的不良反应均经对症处理后缓解,无严重不良反应发生。结论不同AFP亚组患者对索拉非尼的疗效相似,无统计学意义,但AFP在正常值以下者口服索拉非尼的mTTP优于AFP高于正常值者。
Objective To investigate the therapeutic effect of sorafonib combined TACE for advanced hepatocelluar carcinoma（ HCC） according to different serum alpha-fetoprotein（ AFP）level. Methods Between Apri 2009 and Oct 2011,148 patients were grouped according to different serum AFP level, patients with advanced HCC who had received pathology or clinical diagnosis according to BCLC （Barcelona Clinic Liver Cancer）were enrolled and administered with sorafenib （400 mg for twice per day） combined TACE. The tumor response was evaluated according to REC1ST criteria following every 4-6 weeks, and the reverse reaction were recorded and evaluated according to NCI. CTC （3.0 edition）. Results 148 evaluable patients, of which sub-group I （ B stage 22 ; C stage 32） ：SD 39, PD 11, PR 3, CR 1 （liver lesions disappeared）, disease control rate（DCR） was 79% , the median time to tumor progression asked （mTTP） for 6 months ; sub-group Ⅱ （ B stage 13 ; C stage 24 ） ： SD 22, PD 15, PR 0, CR 0, DCR was 59%, mTTP for 4 months; sub-group Ⅲ（ B stage 14 ; C stage 29 ） ： SD 27, PD 16, PR 0, C R 0, DCR was 62% , mTTP for 4 months;sub-groupⅣ （ B stage d ;C stage 10） ：SD 7 ,PD 7 ,PR 0 ,CR 0 ,DCR was 50% ,mTTP for 3 months. Overall disease control rate was 66%. The major adverse events were hand-foot skin reaction, dirrhea, rash and psilosis. Most of them were released after treatment and there was no severe adverse event occurring. Conclusions It is suggested that sorafenib is effective for advanced HCC of different serum AFP level, mTTP are longer in patients with normal AFP than patients with higher AFP.
出处
《中华临床医师杂志（电子版）》
CAS
2012年第7期44-47,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
癌
肝细胞
AFP类
分子靶向治疗
索拉非尼
Carcinoma,hepatocelluar
Alpha-fetoproteins
Molecular targeted therapy
Sorafenib
