TACE联合索拉非尼及消融术序贯治疗大肝癌的临床疗效及其对术后疾病进展时间的影响

摘要/Abstract

摘要： 目的探究经肝动脉化疗栓塞(TACE)联合索拉非尼及消融术序贯治疗大肝癌的临床疗效及其对术后疾病进展时间的影响。方法回顾性收集2020年1月—2022年1月联勤保障部队第九八八医院收治的86例大肝癌患者的临床资料,按治疗方法不同设为对照组(n=40,TACE联合索拉非尼治疗)与研究组(n=46,TACE联合索拉非尼及消融术序贯治疗)。比较两组疗效、甲胎蛋白(AFP)、健康状况、不良反应及生存时间。结果研究组客观缓解率76.09%,明显高于对照组的50.00%(P<0.05);研究组治疗后血清AFP水平[(124.29±20.62)μg/L]低于对照组[(205.13±32.59)μg/L];研究组治疗后KPS评分[(88.68±9.03)分]高于对照组[(79.38±8.15)分],差异均有统计学意义(P<0.05);两组恶心呕吐、腹泻、发热、骨髓抑制、手足皮肤反应等不良反应发生率相比差异无统计学意义(P>0.05);研究组无疾病进展生存时间、总生存时间分别为(16.01±2.15)个月、(19.37±2.69)个月,均明显长于对照组的(11.84±1.62)个月、(13.90±2.04)个月(P<0.05)。结论 TACE联合索拉非尼及消融术序贯治疗大肝癌的临床疗效显著,未明显增加不良反应发生率,可有效延长患者术后无疾病进展生存时间。

关键词: 原发性肝癌, 经肝动脉化疗栓塞, 索拉非尼, 微波消融

Abstract: Objective To investigate the clinical efficacy of sequential treatment of large liver cancer with transarterial chemoembolization (TACE) combined with sorafenib and ablation, and its impact on postoperative disease-free survival time. Methods Clinical data of 86 patients with large liver cancer admitted to the No.988 Hospital of Joint Logistic Support Force from January 2020 to January 2022 were retrospectively collected. They were divided into a control group (n=40, treated with TACE combined with sorafenib) and a study group (n=46, treated with TACE combined with sorafenib and sequential ablation) according to different treatment methods. The efficacy, alpha-fetoprotein (AFP), health status, adverse reactions, and survival time were compared between two groups. Results The objective remission rate of the research group was 76.09%, significantly higher than the control group′s 50.00% (P<0.05); After treatment, the serum AFP level in the study group (124.29 ± 20.62) μg/L was lower than that in the control group (205.13 ± 32.59) μg/L. The KPS score in the study group after treatment (88.68 ± 9.03) was higher than that in the control group (79.38 ± 8.15), and the differences were statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions such as nausea, vomiting, diarrhea, fever, bone marrow suppression, and hand foot skin reactions between the two groups (P>0.05). The progression-free survival time and overall survival time of the study group were (16.01 ± 2.15) months and (19.37 ± 2.69) months, respectively, which were significantly longer than the control group′s (11.84 ± 1.62) months and (13.90 ± 2.04) months (P<0.05). Conclusion TACE combined with sorafenib and sequential ablation therapy has significant clinical efficacy in the treatment of large liver cancer, without significantly increasing the incidence of adverse reactions, and can effectively prolong the postoperative disease-free survival time of patients.

Key words: Primary liver cancer, Transhepatic arterial chemoembolization, Sorafenib, Microwave ablation

王建斌, 梁栋. TACE联合索拉非尼及消融术序贯治疗大肝癌的临床疗效及其对术后疾病进展时间的影响[J]. 肝脏, 2026, 31(6): 822-825.

Wang Jianbin, Liang Dong. Clinical efficacy of TACE combined with sorafenib and ablation in the sequential treatment of large liver cancer and its influence on the time of postoperative disease progression[J]. Chinese Hepatolgy, 2026, 31(6): 822-825.

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