索拉非尼对不同类型原发性肝癌区域性化疗增效作用观察

The effect of sorafenib used after TAIE or TACE in hepatocellular carcinoma of different pathologic types

目的:探讨分子靶向药物对不同病理类型肝细胞肝癌(HCC)经导管肝动脉免疫栓塞(TAIE)或化学栓塞(TACE)治疗的增效作用和不良反应。方法:对不同临床分期和病理类型的HCC分别行TAIE或TACE后,予以索拉非尼口服,每次400mg,bid。4～6周后根据RECIST标准进行肿瘤应答的评价,并记录不良反应。结果:本组小癌型、结节型、巨块型及弥散型肝癌均取得较好疗效,其中CR1例,PR3例。毒副反应除发热、肝痛、恶心、纳减等栓塞后综合征外,服用索拉非尼后2周均出现不同程度的手足综合征,予以中药煎剂浸泡后缓解。结论:索拉非尼联合TAIE或TACE治疗安全有效,可作为不同型期HCC的标准治疗选择之一。

Objective：To study the synergies and adverse reactions of molecular targeted drugs used after transcatheter arterial immune embolization（TAIE） or transcatheter arterial chemoembolization（TACE） in hepatocellular carcinoma（HCC） of different pathological types.Methods：Choose patients with HCC on different clinical stages and of different pathological types.After TACE or TAIE respectively,sorafenib is taken orally 400mg,twice a day.After 4-6 weeks,assessed tumor response and recorded adverse reactions according to RECIST criteria.Results：The treatment to patients of small,nodular,massive and diffuse type of hepatocellular carcinoma all had good efficacy,in which CR 1 cases,PR 3 cases.Toxicity beside the embolism syndrome,such as fever,liver pain,nausea,reduced diet,after taking sorafenib two weeks,all the patients showed varying degrees of hand-foot syndrome,which was alleviated after treated with traditional Chinese medicine by immersing the affect part and taking decoction orally.Conclusion：The treatment that taking sorafenib orally combined with TAIE or TACE is safe and effective,can be used as one of the standard treatments to HCC of different types and on different clinical stages.