TACE联合索拉非尼治疗肝癌合并门静脉癌栓的临床疗效及安全性

摘要/Abstract

摘要： 目的评价经皮导管动脉化疗栓塞术(TACE)联合索拉非尼治疗原发性肝癌(HCC)伴门静脉癌栓(PVTT)的临床疗效及安全性。方法 2015年1月至2016年1月确诊为HCC合并PVTT患者60例,随机分为联合治疗组(n=30)和对照组(n=30)。联合治疗组采用TACE+索拉非尼治疗,对照组采用TACE治疗。用改良实体瘤疗效评价标准(mRECIST)评估疗效。随访观察总生存期(OS)、疾病进展时间(TTP)、疾病控制率(DCR)和毒副反应。结果治疗组DCR为60.0%,对照组DCR为36.7%,治疗组DCR和对照组DCR相比,差异具有统计学意义(P<0.05),治疗组中位OS为10.3个月(95% CI:7.2~13.5),对照组患者OS为5.7个月(95% CI:4.5~6.8),治疗组DCR和对照组DCR相比,差异具有统计学意义(P<0.05);治疗组中位TTP为5.5个月(95% CI:4.6~6.7),对照组中位TTP为3.0个月(95% CI:2.1~3.7),治疗组DCR和对照组DCR相比,差异具有统计学意义(P<0.05)。两组TACE相关不良反应差异无统计学意义,治疗组出现4例索拉非尼相关严重毒副反应,但未出现药物相关死亡患者。结论 TACE联合索拉非尼治疗HCC合并PVTT总体生存期及疾病控制率明显优于单纯TACE治疗,且安全性良好。

关键词: 原发性肝癌, 门静脉癌栓, 经皮导管动脉化疗栓塞, 索拉非尼

陈庆录, 张冠平. TACE联合索拉非尼治疗肝癌合并门静脉癌栓的临床疗效及安全性[J]. 肝脏, 2019, 24(5): 573-576.

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