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1、肝动脉化疗栓塞联合索拉菲尼治疗中晚期肝细胞癌杨明作者单位:解放军第181医院肿瘤科5410022作者单位:第二军医大学附属上海长征医院肝脏外科200003,罗克品1,谢岳云1,邹同祥1,施晓敏2,傅志仁2通讯作者:施晓敏shixiaominmail@sina.com[摘要]目的探讨肝动脉化疗栓塞(TACE)联合索拉菲尼治疗中晚期肝细胞癌(HCC)的临床价值。方法回顾性分析我院2011年1月至2012年1月接受TACE联合索拉菲尼(n=27)或TACE单独治疗(n=25)的中晚期HCC患者的临床资料,采用SPSS13.0软件
2、比较两组患者肿瘤中位进展时间,肿瘤无进展生存率和总生存率。结果随访期间,联合治疗组患者共发生肿瘤进展18例,死亡10例,疾病控制率为74.1%;TACE单独治疗组患者共发生肿瘤进展19例,死亡15例,疾病控制率为68.0%。联合治疗组和TACE单独治疗组患者肿瘤中位进展时间分别为6.5个月和3.3个月(P<0.05),患者6-,12个月的肿瘤无进展生存率分别为51.9%,33.3%和27.6%,16.5%(P<0.05),总生存率分别为81.0%,60.8%和63.3%,34.8%(P<0.05)。联合治疗组患者的手足皮肤
3、反应,口腔粘膜炎发生率较TACE单独治疗组高(P<0.05),药物减量辅以对症治疗后控制良好。结论TACE联合索拉菲尼治疗中晚期HCC是安全有效的,优于TACE单独治疗,值得临床进一步验证推广。[关键词]肝动脉栓塞化疗;索拉菲尼;肝细胞癌;预后COMBINATIONOFTRANSARTERIALCHEMOEMBOLIZATIONWITHSORAFENIBINPATIENTSWITHUNRESECTABLEHEPATOCELLULARCARCINOMA(1.YANGMing,LUOKepin,XIEYueyun,ZOUTon
4、gxiang,DepartmentofOncology,181hospitalofPLA,Guilin,Guangxi541002;2.SHIXiaoming,FUZhiren,Departmentofliversurgery,Changzhenghospital,Shanghai,SecondMilitaryMedicalUniversity,200003.)[Abstract] ObjectiveToevaluatethevalueofcombinationoftransarterialchemoembolizatio
5、n(TACE)withsorafenibinpatientswithunresectablehepatocellularcarcinoma(HCC).MethodsBetweenJanuary2011andJanuary2012,52patientswithunresectableHCCwhowerenotcandidatesforpotentiallycurativetreatmentwereenrolledforthisretrospectiveanalysis.27patientswereadministratedT
6、ACEonceamonthplussorafenib,while25patientsonlyreceivedTACE.SPSS13.0softwarewasusedtoevaluatethemediantimetotumorprogression,progression-freesurvivalandoverallsurvivalrates.ResultsDuringthefollow-up,18patientsinthecombinedtherapygrouphadtumorprogressionand10died,th
7、ediseasecontrolratewas74.1%,while19patientsintheTACEgrouphadtumorprogressionand15died,thediseasecontrolratewas68.0%.Themediantimetotumorprogressionwas6.5monthsand3.3months(P<0.05)incombinedtherapygroupandTACEgroup,respectively.The6-and12-monthprogression-freesurvi
8、valratesincombinedtherapygroupandTACEgroupwere51.9%,33.3%and27.6%,16.5%,respectively(P<0.05).The6-and12-monthpatientoverallsurvivalratesincombinedtherap