TACE联合甲磺酸阿帕替尼治疗中晚期肝癌的临床研究

Clinical Research of Apatinib with Transcatheter Arterial Chemoembolization in Treatment of Advanced Hepatocellular Carcinoma

目的探讨经导管肝动脉化疗栓塞(TACE)联合甲磺酸阿帕替尼对中晚期肝细胞癌的治疗价值,并初步探讨其机制。方法选择我院2014年8月~10月治疗的40例中晚期肝细胞癌患者,随机分为观察组和对照组,每组20例。对照组患者实施TACE治疗方法,观察组患者实施TACE联合口服甲磺酸阿帕替尼治疗。比较两组患者的疗效,并于治疗前及治疗后1个月空腹抽取静脉血,检测血清中血管内皮生长因子(VEGF)和基质金属蛋白酶-9(MMP-9)的水平。结果观察组CR 2例,PR 3例,SD 5例,PD 10例,疾病控制率为50%;对照组CR 0例,PR 2例,SD 2例,PD 16例,疾病控制率为20%,观察组的疾病控制率优于对照组(P<0.05)。两组半年生存率、1年生存率的差异无统计学意义(P>0.05),但观察组的总生存率显著高于对照组(P<0.05)。两组患者治疗前血清VEGF以及MMP-9的含量无显著差异(P>0.05);治疗后1个月两组患者VEGF以及MMP-9的含量均较治疗前下降(P<0.05),且观察组VEGF、MMP-9水平显著低于对照组(P<0.05)。结论 TACE联合甲磺酸阿帕替尼治疗中晚期肝细胞癌的疗效显著,其机制可能与抑制肿瘤新生血管生成有关。

Objective To evaluate the therapeutic value of transcatheter arterial chemoembolization （FACE） combined with Apatinib in the treatment of patients with intermediate or advanced hepatocellular carcinoma and to explore its mechanism. Methods A total of 40 in- termediate or advanced hepatocellular carcinoma in our hospital from August to October 2014 were randomly divided into observation group and a control group, with 20 patients in each group. The patients of the control group were treated with TACE, and the ones in the observa- tion group were treated with Apatinib mesylate and Transcatbeter Arterial Chemoembolization. We compared the clinical effect between the two groups, and the expression of vascular endothelial growth factor （VEGF） and matrix metalloproteinase 9 （MMP-9） in serum at one month before and after treatment. Results CR 2 cases, PR 3 cases, SD 5 cases, PD 10 cases in the observation group and the disease control rate was 50%, while CR 0 cases, PR 2 cases, SD2 cases, PD in 16 cases in the control group and the disease control rate was 20%, the disease control rate in the observation group was better than that in the control group （P〈0.05）; There was no difference between the two groups at the half year survival rate and one year survival rate （P〉 0.05）, the overall survival rate in the observation group was higher than that in the control group （P 〈 0.05）; There was no differences between the two groups in content of VEGF and MMP-9 （P 〉 0.05）. After the treatment, the content of VEGF and MMP-9 was decreased in the two groups （P〈0.05）, but the decrease of VEGF and MMP-9 in the observation group was superior than that in the control group （P〈0.05）. Conclusion There was significant effect inthe treatment of advanced hepatocel- lular carcinoma by TACE combined with Apa imatinib mesylate, the mechanism maybe related to the inhibition of tumor angiogenesis.