肝动脉化疗栓塞术联合阿帕替尼治疗中晚期原发性肝癌疗效评价

Therapeutic effect of transarterial chemoembolization combined with apatinib on patients with advanced hepatocellular carcinoma

目的:评价肝动脉化疗栓塞术(transarterial chemoembolization,TACE)联合口服阿帕替尼治疗中晚期肝癌的近期疗效。方法:收集2016年6月至2016年10月于首都医科大学附属北京友谊医院接受TACE联合口服阿帕替尼250 mg/d治疗的21例中晚期原发性肝癌(hepatocellular carcinoma,HCC)患者的临床资料;采用影像学中最新修订的实体瘤疗效评价标准(modified response evaluation criteria in solid tumors,m RECIST),回顾性分析联合治疗1个疗程(平均约28 d)后患者的治疗效果,并对不良反应进行分析。结果:21例患者中,完全缓解(complete response,CR)3例(14.3%),部分缓解(patial response,PR)6例(28.6%),疾病稳定(stable disease,SD)5例(23.8%)。疾病控制率(disease control rate,DCR)为61.9%,客观缓解率(objective rate,ORR)为38.1%。疾病进展(progressive disease,PD)2例(9.5%)。21例患者治疗中出现的不良反应:乏力17例(94.4%),胃肠道症状14例(66.7%),手足综合征4例(19.0%),血压升高4例(19.0%),并出现不同程度的声音嘶哑、头痛头晕、蛋白尿等。结论:TACE联合阿帕替尼对中晚期原发性肝癌的临床治疗近期效果满意,治疗过程中不良反应发生率较高,需给予积极处理。

Objective： To evaluate the therapeutic effect of transarterial chemoembolization（TACE） combined with apatinib on patients with advanced hepatocellular carcinoma（HCC）. Methods： Twenty-one patients were treated with TACE combined with 250 mg of apatinib once a day. Disease classification was assessed by investigators using the modified Response Evaluation Criteria in Solid Tumors（m RECIST）. The evaluation period was 28 days. Results： The therapeutic effects were classified as follows： 3 patients（14.3%） had complete response, 6 patients（28.6%） had partial response, 5 patients（23.8%） had stable disease, and 2 patients（9.5%） had progressive disease. The disease control rate was 61.9%, and the objective response rate was 38.1%. In patients, the most frequent adverse events were fatigue（94.4%）, anorexia（23.8%）, diarrhea（19.0%）, hypertension（19.0%）, and hand-foot syndrome（19.0%）. Conclusion：The short-term therapeutic effect revealed that the combination of TACE and apatinib could be a promising treatment for patients with advanced HCC. Adverse events should be closely monitored and provided with active management.