肝动脉化疗栓塞联合索拉菲尼在多发性肝细胞癌治疗中的应用研究

Application of Transcatheter Arterial Chemoembolization Combining Sorafenib in Treatment of Multifocal Hepatocellular Carcinoma

目的研究肝动脉化疗栓塞(TACE)联合索拉菲尼在多发性肝细胞癌(MHCC)治疗中的应用效果。方法选取2010年12月至2012年11月于自贡市第四人民医院接受治疗的MHCC患者148例,依据随机数字表法按1∶1的比例分为A、B两组,两组一般资料差异无统计学意义(P>0.05)。A组行单纯TACE治疗,B组行TACE联合索拉菲尼治疗。观察两组治疗前后甲胎蛋白(AFP)、高尔基体蛋白73(GP73)、铁蛋白(FER)、E-钙粘连蛋白(EC)、内皮抑素(E)、癌胚抗原(CEA)、血管内皮生长因子(VEGF)等水平、缓解率、控制率、临床疗效及不良反应。结果治疗后B组AFP、GP73、FER、EC、E、CEA和VEGF水平均低于A组,差异有统计学意义(P<0.05)。B组缓解率、控制率均高于A组,但差异无统计学意义(P>0.05)。B组中位生存时间、总生存时间均高于A组,差异无统计学意义(P>0.05)。B组脱发、腹泻、手足反应等不良反应发生率高于A组,差异有统计学意义(P<0.05),两组不良反应经对症处理后均缓解。结论 TACE联合索拉菲尼治疗MHCC较单纯TACE更有优势。

Objective To study the efficacy of transcatheter arterial chemoembolization（TACE）combining Sorafenibin in the treatment of multifocal hepatocellular carcinoma（MHCC）.Methods 148 patients with MHCC hospitalized in our hospital from December 2010 to November 2012 were selected and randomized into group A and group B in accordance with the random number table at a 1∶1ratio,with no statistically significant difference between the general data of the two groups（P〈0.05）.Group A was treated with single TACE while Group B was treated with TACE combining Sorafenib.Levels of alpha fetoprotein（AFP）,Golgi protein 73（GP73）,ferritin（FER）,E-cadherin（EC）,endostatin（E）,carcinoembryonic antigen（CEA）,vascular endothelial growth factor（VEGF）,remission rate,control rate,clinical effects and adverse reactions were observed before and after treatment.Results After treatment,the levels of AFP,GP73,FER,EC,E,CEA and VEGF of experimental group were higher than those of the control group,the differences of which were statistically significant（P〈0.05）.The remission rate and control rate of Group B were higher than those of the control group,the differences of which were not statistically significant（P〉0.05）.The median survival time and the total survival time of Group B were higher than those of the group A,the differences of which were not statistically significant（P〉0.05）.The incidence rates of adverse reactions including alopecia,diarrhea and hand-foot syndrome in group B were higher than those among group A,the differences of which were statistically significant（P〈0.05）.The hypogenesis symptoms in two groups were both relieved after symptomatic treatment.Conclusion TACE combining Sorafenib was more effective than single TACE in the treatment of MHCC.