索拉非尼联合TACE治疗肝细胞癌的效果及对患者血清因子水平的影响

Clinical effects of sorafenib combined with TACE in the treatment of hepatocellular carcinoma and its impact on serum factor levels in patients

目的 观察索拉非尼联合经肝动脉化疗栓塞术(TACE)治疗肝细胞癌的效果及对患者血清因子水平的影响。方法 选取2021年7月—2022年6月南昌大学第二附属医院收治的中晚期肝细胞癌患者74例,采用随机数字表法分为联合组和TACE组,各37例。TACE组予TACE治疗,联合组在TACE组基础上联合索拉非尼治疗。比较2组近期疗效,治疗前及治疗6个月后肝功能指标[血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、总胆红素(TBil)]、血清因子[甲胎蛋白(AFP)、脱γ-羧基异常凝血酶原(DCP)、血管内皮生长因子(VEGF)],以及不良反应。结果 联合组ORR高于TACE组(56.76%vs.32.43%,χ^(2)=4.431,P=0.035),联合组DCR高于TACE组(86.49%vs.62.16%,χ^(2)=5.736,P=0.017);治疗6个月后,2组ALT、AST、ALP、TBil水平均较治疗前升高,但联合组升高程度小于TACE组(P均<0.01);2组AFP、DCP、VEGF水平均较治疗前降低,且联合组低于TACE组(P均<0.01);联合组与TACE组各项不良反应发生率比较差异均无统计学意义(P>0.05)。结论 索拉非尼联合TACE治疗肝细胞癌的效果满意,一定程度上降低了患者肝功能损伤,对血清因子水平具有积极影响且用药安全性高。

Objective To observe the effects of sorafenib combined with transcatheter arterial chemoembolization(TACE) in the treatment of hepatocellular carcinoma and its impact on the serum factor levels in patients.Methods Seventy-four patients with advanced hepatocellular carcinoma who were admitted to the Second Affiliated Hospital of Nanchang University from July 2021 to June 2022 were selected.They were randomly divided into combined treatment group and TACE group,with 37 cases in each group.The TACE group received treatment with the TACE protocol,while the combined treatment group received sorafenib in addition to the TACE protocol.Compared the short-term efficacy of the two groups,as well as the changes in liver function indicators(ALT,AST,ALP,TBil) and serum factor levels(AFP,DCP,VEGF) before treatment and six months after treatment,and to evaluate adverse reactions.Results The ORR in the combined treatment group was higher than that in the TACE group(56.76% vs.32.43%,χ^(2)=4.431,P=0.035),and the DCR in the combined treatment group was higher than that in the TACE group(86.49% vs.62.16%,χ^(2)=5.736,P=0.017).After 6 months of treatment,the levels of ALT,AST,ALP,and TBil in both groups were higher than before treatment,but the increase was smaller in the combined treatment group than in the TACE group(P<0.01).The levels of AFP,DCP,and VEGF in both groups were lower than before treatment,and the levels were lower in the combined treatment group than in the TACE group(P<0.01).There were no statistically significant differences in the incidence of adverse reactions between the combined treatment group and the TACE group(P>0.05).Conclusion The combination of sorafenib and TACE in the treatment of hepatocellular carcinoma is effective,reducing the degree of liver function damage to a certain extent and positively impacting serum factor levels,with a high level of medication safety.