射频消融联合索拉非尼治疗原发性肝癌疗效分析

Radiofrequency ablation plus Sorafenib for hepatocellular carcinoma

目的评价射频消融术(radiofrequency ablation,RFA)与RFA联合索拉非尼治疗原发性肝癌(hepatocellular carcinoma,HCC)的疗效及安全性。方法 120例HCC患者随机分为对照组68例和观察组52例,对照组单纯给予RFA治疗,观察组行RFA联合索拉非尼治疗。随访观察2组患者1、2、3a生存率,比较2组疗效、中位生存期及不良反应发生情况。结果治疗1个月后观察组总有效率(92.3%)高于对照组(75.0%)(P<0.05);观察组1、2、3a生存率分别为94.2%、80.7%、71.1%,对照组分别为79.4%、63.2%、39.7%,2组1、2a生存率比较差异无统计学意义(P>0.05),3a生存率比较差异有统计学意义(P<0.05),且观察组中位生存期(23.1个月)较对照组(16.7个月)长(P<0.05);2组门静脉及胆道损伤、肝包膜出血、膈肌损伤、消化道出血发生率比较差异无统计学意义(P>0.05),观察组皮疹(40.4%)、腹泻(28.8%)、恶心呕吐(17.3%)、发热乏力(65.4%)发生率高于对照组(4.4%、4.4%、2.9%、19.1%)(P<0.05)。结论索拉非尼联合RFA治疗HCC可延长患者生存期,提高生存率,但不良反应较重。

Objective To compare the effect and safety between radiofrequency ablation（RFA）plus Sorafenib and RFA alone in the treatment of hepatocellular carcinoma（HCC）.Methods A total of 120 patients with HCC were randomly divided into observation group（n=68）and control group（n=52）.Control group was given RFA therapy and observation group was given Sorafenib besides RFA therapy.The 1-,2-and 3-year survival rates were followed up,and the therapeutic effect,median survival time and adverse reaction were compared between two groups.Results After one month follow-up survey,the total remission rate was higher in observation group（92.3%）than that in control group（75.0%）（P〈0.05）.There were no significant differences in 1-and 2-year survival rates between observation group（94.2%,80.7%）and control group（79.4%,63.2%）（P〉0.05）,and there was a significant difference in 3-year survival rate between observation group（71.1%）and control group（39.7%）（P〉0.05）.The median survival time was longer in observation group（23.1months）than that control group（16.7months）（P〈0.05）.There were no significant differences in the incidences of injury of portal vein and bile duct,subcapsular hemorrhage of liver,diaphragmatic injury and alimentary tract hemorrhage（P〈0.05）.The incidences of rash（40.4%）,diarrhea（28.8%）,vomiting（17.3%）,and fever and fatigue（65.4%）in observation group were significantly higher than those in control group（4.4%,4.4%,2.9% 19.1%）（P〈0.05）.Conclusion Sorafenib plus RFA can prolong the survival time and improve survival rate in patients with HCC,but the adverse reactions are severe.