DEB-TACE联合索拉非尼对肝细胞癌的临床疗效

Clinical efficacy of drug-eluting beads transcatheter arterial chemoembolization combined with sorafenib for hepatocellular carcinoma

目的评估国产载药微球动脉化疗栓塞(DEB-TACE)联合索拉非尼治疗肝细胞癌(HCC)的临床疗效。方法收集2017年10月至2019年10月于兰州大学第二医院收治的47例HCC患者的临床资料,根据治疗方法的不同将其分为观察组[给予DEB-TACE联合索拉非尼,n=26)]和对照组(给予单纯DEB-TACE,n=21),比较两组患者的临床疗效、手术前后的实验室指标及不良反应发生情况。结果术后12个月,两组患者的疾病控制率(DCR)比较,差异有统计学意义(P<0.05);两组患者的客观缓解率(ORR)比较,差异无统计学意义(P>0.05)。两组患者术前与术后1个月的各肝功能指标比较,差异均无统计学意义(P>0.05)。术后1个月,两组患者的血清甲胎蛋白(AFP)水平均明显低于本组术前,且观察组患者的血清AFP水平低于对照组患者,差异有统计学意义(P<0.05)。两组患者手足综合征的发生率比较,差异有统计学意义(P<0.05)。两组患者均未发生严重的3、4级不良反应。结论采用国产DEB-TACE联合索拉非尼治疗HCC,能够降低术后AFP水平,临床疗效较好。虽然不良反应的发生比例明显增加,但均在安全范围之内。

Objective To evaluate the clinical efficacy of drug-eluting beads transcatheter arterial chemoembolization(DEB-TACE)combined with sorafenib in the treatment of hepatocellular carcinoma(HCC).Method The clinical data of 47 patients with HCC treated in Lanzhou University Second Hospital from October 2017 to October 2019 were collected.They were divided into observation group(DEB-TACE combined with sorafenib,n=26)and control group(DEB-TACE,n=21).The clinical efficacy,laboratory indexes and adverse reactions before and after operation were compared between the two groups.Result There was significant difference in disease control rate(DCR)between the two groups 12 months after operation(P<0.05).There was no significant difference in objective response rate(ORR)between the two groups(P>0.05).There was no significant difference in liver function indexes between the two groups before operation and 1 month after operation(P>0.05).One month after operation,the levels of alpha-fetoprotein(AFP)in the two groups were significantly lower than those before operation,and the level of serum AFP in the observation group was lower than that in the control group(P<0.05).There was significant difference in the incidence rate of hand foot syndrome between the two groups(P<0.05).No serious grade 3 and 4 adverse reactions occurred in both groups.Conclusion Using DEB-TACE combined with sorafenib in the treatment of HCC can reduce the level of AFP after operation,and the clinical effect is good.Although the incidence of adverse reactions increased significantly,they were all within the safe range.