肝动脉化疗栓塞术联合甲磺酸阿帕替尼片治疗晚期肝癌的疗效及安全性评价

Efficacy and Safety of Transarterial Chemoembolization Combined with Apatinib Mesylate in Patients with Advanced Hepatocellular Carcinoma

摘要: 目的：探讨经动脉化疗栓塞(TACE)联合阿帕替尼治疗晚期肝细胞癌(HCC)的临床疗效和安全性。方法：收集2017年12月至2018年10月在新汶矿业集团中心医院接受TACE联合阿帕替尼治疗40例晚期肝癌患者临床资料，分别在TACE治疗后的第1个月和第3个月评估治疗反应，评价远期疗效和不良反应。结果：治疗后1个月的客观缓解率和疾病控制率分别为62.50%和92.50%。治疗后3个月，客观应答率(65.00%)略高，疾病控制率(90.00%)较低。术后1月或术后3月的天冬氨酸氨基转移酶、丙氨酸氨基转移酶、血清白蛋白或总胆红素水平与术前相比无差异(均p > 0.05)。中位无进展生存期为10.50个月(95% CI，8.95~12.05个月)，中位总生存期为23.00个月(95% CI，14.95~31.07个月)。在40例患者中，4名患有高血压，2名患有3级腹泻；其余患者有轻度到中度的可接受的不良反应，没有发生严重的不良反应。结论：TACE联合阿帕替尼治疗晚期肝癌是一种安全、有前景的治疗方法。

Abstract: Objective: To investigate the clinical efficacy and safety of transarterial chemoembolization (TACE) combined with apatinib in the treatment of advanced hepatocellular carcinoma (HCC). Methods: The clinical data of 40 patients with advanced liver cancer treated with TACE combined with apatinib in Central Hospital of Xinwen Mining Group from December 2017 to October 2018 were collected. The treatment response was evaluated in the first month and the third month after TACE treatment, respectively. The longterm efficacy and adverse reactions were evaluated. Results: One month after treatment, the objective remission rate and disease control rate were 62.50% and 92.50%, respectively. Three months after treatment, the objective response rate (65.00%) was slightly higher, and the disease control rate (90.00%) was lower. The levels of aspartate aminotransferase, alanine aminotransferase, serum albumin or total bilirubin in one month after interventional therapy or three month after interventional therapy were not different from those in M0 (p > 0.05). The median progression-free survival was 10.50 months (95% CI, 8.95 - 12.05 months), and the median overall survival time was 23.00 months (95% CI, 14.95 - 31.07 months). Of the 40 patients, 4 had hypertension and 2 had grade 3 diarrhea; The rest had mild to moderate acceptable adverse reactions and no serious adverse reactions. Conclusion: TACE combined with apatinib is a safe and promising method for the treatment of advanced liver cancer.