经导管肝动脉化疗栓塞联合索拉非尼治疗不能手术切除肝细胞肝癌的疗效

Curative efficacy of transcatheter arterial chemoembolization combined with sorafenib for unresectable hepatocellular carcinoma

目的探讨经导管肝动脉化疗栓塞联合索拉非尼对不能手术切除的中晚期肝细胞肝癌的疗效。方法选取收治的肝细胞肝癌患者160例,采用随机数字法分为联合组(n=82)和对照组(n=78)。联合组患者给予经导管肝动脉化疗栓塞联合索拉非尼治疗,对照组患者给予经导管肝动脉化疗栓塞治疗。比较两组患者治疗后疗效、生活质量、肝功能状况、生存率和不良反应情况。结果联合组患者治疗总有效率和生活质量改善率分别为97.6%(80/82)和89.0%(73/82),优于对照组的59.0%(46/78)和53.9%(42/78,P<0.0.5);两组患者治疗后丙氨酸氨基转移酶(ALT)和总胆红素(TBIL)水平均高于治疗前(均P<0.05),而治疗前后白蛋白(ALB)水平差异无统计学意义(P>0.05);联合组患者1、2年生存率均高于对照组(均P<0.05);两组患者不良反应发生率差异无统计学意义(P=0.557)。结论经导管肝动脉化疗栓塞联合索拉非尼治疗疗效优于单经导管肝动脉化疗栓塞治疗,可有效改善患者的生活质量和肝功能,提高生存率。

Objective To observe the curative efficacy of transcatheter arterial chemoembolization combined with sorafenib for unresectable hepatocellular carcinoma. Methods 160 unresectable hepatocellular carcinoma patients who were treating in Dongguan People＇s Hospital from January 2009 to December2013 were enrolled in the study. They were randomly divided into the combined group（ n = 82） and the control group（ n = 82）. The curative effect,quality of life,liver function,survival rate and adverse reactions were compared between the two groups. Results The total effective rate and quality of life improvement rate in the combined group were 97. 6%（ 80 /82） and 89. 0%（ 73 /82）,higher than 59. 0%（ 46 /78） and 53. 9%（ 42 /78） in the control group（ P〈0. 05）. The levels of alanine aminotransferase（ ALT）and total bilirubin（ TBIL） after therapy in both groups were all raised（ P〈0. 05）,while the levels of albumin（ ALB） maintained（ P〉0. 05）. The 1-yr and 2-yr survival rate in the combined group were higher than those in the control group（ all P〈0. 05）. The incidence of adverse reactions between these two groups has no statistical difference（ P〉0. 05）. Conclusion Compared to the transcatheter arterial chemoembolization,transcatheter arterial chemoembolization combined with sorafenib could achieve better curative effects,which can improved the quality of life and liver function and prolong survival rate.