索拉菲尼治疗手术后复发或栓塞后进展的原发性肝癌的疗效观察

The Observation of Short-term Therapeutic Effect to Combined Sorafenib in the Treatment of Primary Hepatocellular Carcinoma Recurrent after Surgery or Advanced after Transhepatic Artery Chemoembolization

目的观察联合索拉菲尼治疗外科术后复发或经肝动脉化疗栓塞(TACE)后进展的原发性肝癌近期临床疗效。方法搜集自2015年1月以来18例BCLC分期B/C期的原发性肝癌患者,外科术后复发或TACE治疗进展后联合口服索拉菲尼400mg,2次/日;采用mRESET标准1月、3月、6月、12月影像学(强化CT/MR)随访评价病灶控制效果,计算至疾病进展时间(TTP)和中位总生存时间(OS),并统计索拉菲尼药物副反应情况。结果 18例患者自服用索拉菲尼后平均TTP 6.4个月,中位OS16.5个月。11例出现2级以下药物不良反应,2例3级药物不良反应(其中1例严重腹泻、1例严重手足皮肤反应),对症治疗并降低药物剂量后不良反应缓解,未影响继续治疗。结论对于外科术后复发或TACE治疗后进展的原发性肝癌(BCLC分期B/C期),联合口服甲磺酸索拉菲尼,临床效果较好,不良反应少。

Objective To observe the short-term clinical efficacy of combined therapy with Sorafenib in the treatment of primary hepatocellular carcinoma(TACE) with recurrence after surgery or progression after transcatheter arterial chemoembolization(TACE).Methods Eighteen patients with BCLC stage B/C primary hepatocellular carcinoma since January 2015 were enrolled in this study. After recurrence or TACE treatment,they were treated with oral Sorafenib 400 mg PO, bid. The effect of focal control was evaluated by mRESET standard 1 months,3 months,6 months and 12 months follow-up imaging(enhanced CT/MR). TTP and median total time of disease progression were calculated. Survival time(OS) and side effects of Sorafenib were counted.Results The average TTP of 18 patients was 6.4 months(median OS 16.5 months) after taking Sorafenib. 11 patients had adverse drug reactions below grade 2 and 2 patients had adverse drug reactions below grade 3(including 1 case of severe diarrhea and 1 case of severe hand-foot skin reactions). After symptomatic treatment and lower drug dosage,the adverse reactions were alleviated without affecting the continued treatment. Cure.Conclusion For primary hepatocellular carcinoma(BCLCstageB/C) with recurrence after surgery or progression after TACE treatment,combined with oral Sorafenib mesylate has better clinical effect and fewer adverse reactions.