舒尼替尼与索拉非尼治疗晚期肝细胞癌的效果比较

Clinical effect of two targeted drugs in treatment of advanced hepatocellular carcinoma: A comparative analysis

目的探究靶向药物舒尼替尼应用于晚期肝细胞癌(HCC)治疗的临床疗效。方法将2015年9月-2016年9月长安医院收治的48例晚期HCC患者纳入研究,按照治疗药物的不同分为对照组和观察组,每组24例。对照组患者口服索拉非尼治疗,观察组口服舒尼替尼治疗。随访观察1年后,记录两组患者的临床疗效、临床症状改善以及不良反应情况。计量资料组间比较采用t检验,计数资料组间比较采用Mann-Whitney U检验。结果观察组的疾病控制率为68.42%(13/19),其中有效缓解4例,病情控制稳定9例;对照组的疾病控制率为76.19%(16/21),两组的疾病控制率差异无统计学意义(P>0.05)。对照组手足皮肤反应发生率为12.5%,观察组为0,两组比较差异有统计学意义(U=31.07,P<0.05)。观察组中性粒细胞减少发生率为25%,明显高于对照组(16.67%)(U=29.87,P<0.05)。两组均出现消化道反应如恶心、呕吐等以及肝功能异常,因患者胃肠道反应可耐受未进行处理,肝功能异常患者给予保肝药物等处理,均得到有效缓解。结论舒尼替尼在治疗晚期HCC中有良好的临床效果,需要对更大样本量、更长期的临床效果和联合治疗进行深入的研究和探讨。

Objective To investigate the clinical effect of the targeted drug sunitinib in the treatment of advanced hepatocellular carcinoma（ HCC）. Methods A total of 48 patients with advanced HCC who were admitted to Chang＇an Hospital form September 2015 to September2016 were enrolled and divided into control group and observation group,with 24 patients in each group. The patients in the control group were given oral sorafenib,and those in the observation group were given oral sunitinib. The patients were followed up for 1 year,and the clinical outcome,improvement in clinical symptoms,and adverse events were recorded. The t-test was used for comparison of continuous data between groups,and the Mann-Whitney U test was used for comparison of categorical data between groups. Results The disease control rate（ DCR） in the observation group was 68. 42%（ 13/19）,and among these 13 patients,4 achieved effective remission and 9 had stable disease; the DCR in the control group was 76. 19%,and there was no significant difference in DCR between the two groups（ P〉 0. 05）.There was a significant difference in the incidence rate of hand-foot skin reaction between the observation group and the control group（ 0%vs 12. 5%,U = 31. 07,P 〈0. 05）. The observation group had a significantly higher incidence rate of neutropenia than the control group（ 25% vs 16. 67%,U = 29. 87,P〈 0. 05）. Both groups experienced digestive tract reactions（ nausea and vomiting） and abnormal liver function; since the digestive tract reactions were tolerable,no special treatment was given,and the patients with abnormal liver function were given liver-protecting drugs,so all adverse events were effectively alleviated. Conclusion Sunitinib has a good clinical effect in the treatment of advanced HCC,and further studies with a larger sample size are needed to investigate the long-term clinical effect of sunitinib and combined treatment.