摘要
目的:探讨肝动脉化疗栓塞术(transcather arterial chemoembolization,TACE)联合甲磺酸阿帕替尼片和单纯TACE治疗中晚期原发性肝癌疗效的差异。方法 :以在本院接受TACE治疗的60例中晚期肝癌患者为研究对象,研究分为2组:TACE联合甲磺酸阿帕替尼片治疗组(30例)作为观察组,TACE单独治疗组(30例)作为对照组。对比2组患者在治疗前和治疗后3个月的血清甲胎蛋白(alpha-fetoprotein,AFP)、血管内皮生长因子(vascular endothelial growth factor,VEGF)和基质金属蛋白酶9(matrix metalloproteinase-9,MMP-9)浓度,同时比较2组患者治疗后的肿瘤客观缓解率、总生存率以及不良反应发生率。结果 :2组患者治疗前血清中AFP、VEGF和MMP-9浓度差异均无统计学意义(P值均> 0.05);治疗后3个月时,2组患者血清中AFP、VEGF和MMP-9浓度均较治疗前明显下降(P值均<0.05),且观察组患者血清中AFP、VEGF和MMP-9的浓度均明显低于对照组,差异有统计学意义(P值均<0.05)。治疗6个月时,观察组患者的客观缓解率较对照组有所提高,但差异无统计学意义(χ~2=1.148,P=0.284);治疗12个月时,观察组患者客观缓解率较对照组明显改善,差异有统计学意义(χ~2=5.963,P=0.015)。对照组和观察组6个月、1年和2年时的生存率分别为83.3%、52.4%、15.0%和93.3%、66.7%、38.6%,中位生存时间分别为14和19个月,观察组总生存率高于对照组(χ~2=4.414,P=0.036)。2组患者发热、腹痛、恶心呕吐、骨髓抑制、腹泻、乏力和瘙痒发生率经比较,差异均无统计学意义(P值均> 0.05);而观察组患者高血压、蛋白尿、手足综合征以及皮疹发生率均较对照组明显增高,差异有统计学意义(P值均<0.05)。结论 :与单纯TACE相比,TACE联合甲磺酸阿帕替尼片治疗中晚期肝癌能取得更好的临床疗效和生存周期,但同时相关不良反应发生率有所增加。
Objective： To explore the difference of curative effect between transcather arterial chemoembolization（TACE） combined with apatinib mesylate tablets and TACE alone in the treatment of intermediate and advanced primary hepatoma.Methods： Total of 60 patients with intermediate and advanced hepatoma treated by TACE were divided into the observation group（30 cases） and the control group（30 cases） according to whether TACE combined with apatinib mesylate tablets or not. The serum levels of alpha-fetoprotein（AFP）, vascular endothelial growth factor（VEGF）, and matrix metalloproteinase-9（MMP-9） before and 3 months after the treatment were compared. And the objective remission rate, overall survival, and the incidence of adverse effects between the two groups were also compared.Results： The serum levels of AFP, VEGF, and MMP-9 before treatment were not significantly different between the two groups（all P 〉0.05）, but the ones were all decreased in the two groups 3 months after treatment（all P 〈0.05）. The serum levels of AFP, VEGF, and MMP-9 after treatment in the observation group were all lower than those in the control group（all P 〈0.05）. The objective remission rate in the observation group 6 months after treatment was increased, though the difference was not statistically significant（χ^2 = 1.148, P = 0.284）. The objective remission rate in the observation group 12 months after treatment was significantly increased（χ^2 = 5.963, P = 0.015）. The 6-month, 1-year, and 2-year survival rates were 83.3%, 52.4% and 15.0% in the control group, while 93.3%, 66.7% and 38.6% in the observation group, respectively. The median survival time in the control group and the observation group were 14 and 19 months, respectively. The overall survival in the observation group was higher than that in the control group（χ^2 = 4.414, P = 0.036）. The occurrence rates of fever, stomachache, nausea and vomiting, myelosuppression, diarrhea, weak, and pruritus were not significantly different between the two groups（all P 〉0.05）. However, the occurrence rates of hypertension, proteinuria, hand-foot syndrome, and rash in the observation group were significantly higher than those in the control group（all P〈 0.05）.Conclusion： Compared with the treatment of TACE alone, TACE combined with apatinib mesylate can get better clinical efficacy and survival in the treatment of intermediate and advanced primary hepatoma, but with an increased adverse effects rate.
作者
黄锐
姚立正
李文会
王学俊
HUANG Rui, YAO Lizheng, LI Wenhui, WANG Xuejun(Department of Intervention, Yancheng Third People＇ s Hospital, Yancheng 224005, Jiangsu Province, China)
出处
《肿瘤》
CAS
CSCD
北大核心
2018年第10期965-972,共8页
Tumor
关键词
肝肿瘤
化学栓塞
治疗性
抗肿瘤联合化疗方案
甲磺酸阿帕替尼片
预后
Liver neoplasms
Chemoembolization
therapeutic
Antineoplastic combinedchemotherapy protocols
Apatinib mesylate tablets
Prognosis
