肝动脉化疗栓塞术联合阿帕替尼治疗中晚期原发性肝癌疗效评价

Therapeutic effect of transarterial chemoembolization combined with apatinib on patientswith advanced hepatocellular carcinoma

    摘要
  • 摘要:
      目的  评价肝动脉化疗栓塞术（transarterial chemoembolization，TACE）联合口服阿帕替尼治疗中晚期肝癌的近期疗效。
      方法  收集2016年6月至2016年10月于首都医科大学附属北京友谊医院接受TACE联合口服阿帕替尼250 mg/d治疗的21例中晚期原发性肝癌（hepatocellular carcinoma，HCC）患者的临床资料；采用影像学中最新修订的实体瘤疗效评价标准（modified responseevaluation criteria in solid tumors，mRECIST），回顾性分析联合治疗1个疗程（平均约28 d）后患者的治疗效果，并对不良反应进行分析。
      结果  21例患者中，完全缓解（complete response，CR）3例（14.3%），部分缓解（patial response，PR）6例（28.6%），疾病稳定（stable disease，SD）5例（23.8%）。疾病控制率（disease control rate，DCR）为61.9%，客观缓解率（objective rate，ORR）为38.1%。疾病进展（progressive disease，PD）2例（9.5%）。21例患者治疗中出现的不良反应：乏力17例（94.4%），胃肠道症状14例（66.7%），手足综合征4例（19.0%），血压升高4例（19.0%），并出现不同程度的声音嘶哑、头痛头晕、蛋白尿等。
      结论  TACE联合阿帕替尼对中晚期原发性肝癌的临床治疗近期效果满意，治疗过程中不良反应发生率较高，需给予积极处理。

     

    Abstract:
      Objective  To evaluate the therapeutic effect of transarterial chemoembolization(TACE)combined with apatinib on patients with advanced hepatocellular carcinoma(HCC).
      Methods  Twenty-one patients were treated with TACE combined with 250 mgof apatinib once a day.Disease classification was assessed by investigators using the modified Response Evaluation Criteria in Solid Tumors(mRECIST).The evaluation period was 28 days.
      Results  The therapeutic effects were classified as follows: 3 patients(14.3%)hadcomplete response, 6 patients(28.6%)had partial response, 5 patients(23.8%)had stable disease, and 2 patients(9.5%)had progressive disease.The disease control rate was 61.9%, and the objective response rate was 38.1%.In patients, the most frequent adverseevents were fatigue(94.4%), anorexia(23.8%), diarrhea(19.0%), hypertension(19.0%), and hand-foot syndrome(19.0%).
      Conclusion  The short-term therapeutic effect revealed that the combination of TACE and apatinib could be a promising treatment for patientswith advanced HCC.Adverse events should be closely monitored and provided with active management.

     

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