摘要
目的比较TACE联合阿帕替尼与单纯TACE治疗中晚期肝细胞癌的临床疗效和安全性。方法将44例肝细胞癌患者随机平均分为A、B组,对A组行单纯TACE治疗,B组行TACE联合阿帕替尼治疗。比较两组治疗后3个月时甲胎蛋白(AFP)指标变化,及3、6、9、12个月时客观缓解率(ORR)。同时比较两组患者疾病无进展生存期(PFS)和不良反应的发生情况。结果治疗后3个月,A、B组AFP水平均显著下降,较治疗前差异均有统计学意义(Z=-2.289、-2.953,P均<0.05),治疗后两组间比较差异无统计学意义(Z=-0.126,P=0.90)。3、6个月时两组ORR差异无统计学意义(P均>0.05),9、12个月时差异有统计学意义(P均<0.05)。两组PFS差异有统计学意义(X^2=6.576,P=0.01)。B组阿帕替尼相关并发症(包括高血压、手足综合征、蛋白尿)发生率高于A组,差异均有统计学意义(P均<0.05)。不良反应经对症处理后均缓解。结论对于中晚期肝细胞癌患者,TACE联合阿帕替尼的中远期疗效优于单纯TACE治疗,且具有一定的安全性。
Objective To evaluate the efficacy and safety of TACE combined with Apatinib versus TACE monotherapy in the treatment of advanced hepatocellular carcinoma （HCC）. Methods A total of 44 patients with advanced HCC were enrolled and divided randomly into group A （n=22） and group B （n=22）. The patients in group A were treated with TACE monotherapy while group B were treated with TACE combined with Apatinib. The serum alpha fetoprotein （AFP） levels were compared between the two groups three months after treatment. The objective response rate （ORR） after 3, 6, 9 and 12 months, the progression-free survival （PFS） and incidence of adverse reactions were also compared. Results The serum AFP levels decreased apparently in two groups three months after treatment, and statistic differences were observed in each group （Z=-2.289, -2.953, both P 〈0.05）, while no statistic differences was obtained between the two groups after treatment （Z=-0.126, P 〉0.05）. No statistic differences were found in ORR between the two groups 3 and 6 months after treatment （both P 〉0.05）, while statistic differences were manifested after 9 and 12 months （both P 〈0.05）. The medium PFS in group A significantly lower than that in group B （χ^2=6.576, P=0.01）. The apatinib-related adverse reactions including hypertension, hand-foot syndrome and proteinuria in group B were higher than those in group A, and statistically significant difference were obtained （allP〈0.05）. The adverse reactions were relieved after symptomatic treatment. Conclusion TACE combined with apatinib may improve the mid-long term efficacy in patients with advanced HCC. And the relatively safety of TACE combined with apatinib is confirmed.
出处
《中国介入影像与治疗学》
CSCD
北大核心
2017年第4期200-204,共5页
Chinese Journal of Interventional Imaging and Therapy
基金
中国人民解放军海军总医院人才引进专项基金(RCYJZX-009)
关键词
癌
肝细胞
阿帕替尼
化学栓塞
治疗性
疗效
不良反应
Carcinoama, hepatocellular
Apatinib
Chemoembolization, therapeutic
EKicacy
Adverse reactions
