DEB-TACE联合瑞戈非尼二线治疗不可切除晚期肝细胞癌的疗效和安全性

Efficacy and safety of DEB-TACE combined with regorafenib for the second-line treatment of unresectable advanced hepatocellular carcinoma

目的探讨载药微球经导管动脉化疗栓塞术(DEB-TACE)联合瑞戈非尼二线治疗不可切除晚期肝细胞癌的疗效及安全性。方法回顾性分析34例接受一线治疗后肿瘤进展的不可切除晚期肝细胞癌患者的临床资料,依据治疗方案分为观察组(n=15)和对照组(n=19)。对照组仅接受瑞戈非尼单药治疗,观察组接受瑞戈非尼联合DEB-TACE治疗。依据改良的实体瘤疗效评价标准比较两组患者的客观缓解率、疾病控制率,以及无进展生存期、总生存期;记录治疗期间患者的不良反应发生情况。结果首次治疗后2个月,观察组的客观缓解率、疾病控制率均高于对照组(均P<0.05);两组患者的中位随访时间为12.5个月,观察组中位无进展生存期、中位总生存期均优于对照组(均P<0.05)。两组发生的与瑞戈非尼相关的不良反应发生率比较,差异无统计学意义(P>0.05);观察组中,与DEB-TACE相关的不良反应主要为发热、疼痛、恶心及呕吐,均经对症治疗后缓解。结论不可切除晚期肝细胞癌患者采用DEB-TACE联合瑞戈非尼二线治疗可以提高客观缓解率和疾病控制率,延长患者的无进展生存期和总生存期,安全性和耐受性良好。

Objective To explore the efficacy and safety of drug-eluting beads transcatheter arterial chemoembolization(DEB-TACE)combined with regorafenib for the second-line treatment of unresectable advanced hepatocellular carcinoma.Methods The clinical data of 34 patients with unresectable advanced hepatocellular carcinoma,whose tumor was progressive after receiving the first-line treatment,were retrospectively analyzed,and they were assigned to observation group(n=15)or control group(n=19)according to therapeutic regimes.The control group only received regorafenib monotherapy,and the observation group received regorafenib combined with DEB-TACE for treatment.According to the modified Response Evaluation Criteria In Solid Tumors standard,the objective response rate,disease control rate of patients,and progression-free survival and total survival were compared between patients of the two groups;furthermore,the occurrence of adverse reactions during treatment was recorded in patients.Results After 2 months of first time treatment,the objective response rate and the disease control rate of the observation group were higher than those of the control group(all P<0.05),and the median follow-up time for both groups was 12.5 months,as well as the observation group yielded superior median progression-free survival and median total survival to compared with the control group(all P<0.05).No statistically significant difference in the incidence rate of adverse reactions related to regorafenib was found between the two groups(P>0.05).In the observation group,the adverse reactions related to DEB-TACE were mainly fever,pain,nausea and vomiting,etc.,and all of them were relived after symptomatic treatment.Conclusion For patients with unresectable advanced hepatocellular carcinoma,employing DEB-TACE combined with regorafenib for the second-line treatment can increase the rates of objective response and disease control,prolong patients′progression-free survival and total survival,exerting a favourable safety and tolerance.