CalliSpheres联合阿帕替尼治疗肝癌的安全性和有效性

The safety and effectiveness of CalliSpheres combined with apatinib for the treatment of hepatocellular carcinoma

目的探讨Callispheres载药微球联合阿帕替尼治疗肝癌的安全性与有效性。方法回顾性分析昆明医科大学第一附属医院2017年7月至2018年10月采用载药微球(DEB)-TACE联合阿帕替尼治疗的37例肝癌患者,临床疗效根据改良实体肿瘤评价标准进行评价,并评估DEB-TACE术后并发症与口服阿帕替尼的不良反应。结果患者接受治疗后1、3个月的总有效率(ORR)分别为83.7%、80.8%。其中位无进展生存期(mPFS)为6.1个月,中位的总生存期(mOS)为13.8个月。DEB-TACE术后不良反应主要有发热、腹痛、肝功能受损等;阿帕替尼不良反应主要为手足综合征、皮肤色素沉着症、继发性高血压等。所有不良反应均未超过3级且可通过对症支持治疗或减少阿帕替尼的服药剂量进行控制。结论CalliSpheres载药微球联合阿帕替尼为肝癌患者提供一种效益较高的治疗方案,且不良反应轻,易耐受,值得临床进一步推广应用。

Objective To investigate the safety and effectiveness of CalliSpheres drug-eluting beads(DEB)combined with apatinib for the treatment of hepatocellular carcinoma(HCC).Methods The clinical data of a total of 37 HCC patients,who received DEB transcatheter arterial chemoembolization(DEB-TACE)combined with apatinib at the First Affiliated Hospital of Kunming Medical University of China during the period from July 2017 to October 2018,were retrospectively analyzed.The clinical curative effect was evaluated according to modified Response Evaluation Criteria in Solid Tumors,and the Common Terminology Criteria for Adverse Events was used to evaluate the postoperative complications of DEB-TACE and side effects of oral apatinib.Results The one-month and 3-month postoperative overall response rates(ORR)were 83.7%and 80.8%respectively.The median progression-free survival(mPFS)time was 6.1 months,and the median overall survival(mOS)time was 13.8 months.The postoperative adverse reactions of DEB-TACE mainly included fever,abdominal pain,liver function damage,etc.,and the main side effects of apatinib were hand-foot syndrome,skin pigmentation and secondary hypertension.None of the degree of adverse events exceeded grade 3,and all the adverse events could be controlled by symptomatic supportive care or by reducing the dose of apatinib.Conclusion CalliSpheres DEB combined with apatinib provide a high effective therapeutic scheme for HCC patients,its adverse reactions are mild and tolerable.Therefore,this treatment is worth further popularization and application.