索拉非尼联合肝动脉灌注化疗治疗晚期肝细胞癌的疗效观察

Clinical Efficacy of Sorafenib Combined with Hepatic Artery Infusion Chemotherapy to Treat Advanced hepatocellular carcinoma

目的探讨索拉非尼联合肝动脉灌注化疗治疗晚期肝细胞癌的临床疗效。方法根据不同治疗方案将60例晚期肝癌患者分位单纯口服索拉非尼组(单药组20例)、肝动脉灌注化疗组(HAIC组20例)、索拉非尼联合肝动脉灌注化疗(联合组20例),比较三组患者临床疗效和远期生存情况。结果联合组总有效率明显高于单药组以及HAIC组,差异具有统计学意义(P<0.05);进一步分析显示,联合组患者中位生存时间和中位进展期明显优于单药组及HAIC组,差异均具有统计学意义(P<0.05)。然而,联合组不良反应事件,包括:骨髓抑制、手足反应、恶心及呃逆、皮疹、高血压等发生率均明显高于单药组及HAIC组,差异具有显著性(P<0.05)。结论索拉非尼联合肝动脉灌注化疗可显著提高晚期肝细胞癌患者的临床疗效及远期存活情况,可以作为治疗晚期肝癌患者的首选策略,但需注意预防不良反应的发生。

Objective To investigate the clinical efficacy of sorafenib combined with hepatic artery infusion chemotherapy(HAIC)in the treatment of advanced hepatocellular carcinoma(HCC).Methods Based on the differences of treatments,60 patients with advanced HCC were divided into three groups including oral sorafenib alone(monotherapy group,20 patients),HAIC(HAIC group,20 patients),and sorafenib+HAIC(combined group,20 patients),and the clinical efficacy and long-term survival of the three groups were compared.Results The total effective rate of the combined group was significantly higher than that of the monotherapy group and the HAIC group,and the difference was statistically significant(P<0.05).Furthermore,the median survival time and the median time to progression of patients in the combination group were significantly superior to those in the other two groups,and the difference was statistically significant(P<0.05).However,the incidence of adverse events,including bone marrow suppression,hand-foot-syndrome,nausea,hiccup,skin rash and hypertension,was significantly higher in the other two groups,the difference was statistically significant(P<0.05).Conclusion Sorafenib combined with HAIC can significantly improve the clinical efficacy and long-term survival of patients with advanced HCC,and can be the preferred treatment strategy for patients,however,it is necessary to pay attention to the prevention of adverse reactions.