经肝动脉化疗栓塞术联合阿帕替尼治疗中晚期原发性肝癌的效果及安全性分析

武健; 尹芳; 罗贯虹; 郑洋洋; 李红; 朱绍华; 张静; 周新民

doi:10.3969/j.issn.1001-5256.2018.04.016

经肝动脉化疗栓塞术联合阿帕替尼治疗中晚期原发性肝癌的效果及安全性分析

DOI: 10.3969/j.issn.1001-5256.2018.04.016

空军军医大学西京医院消化内科

详细信息

中图分类号: R735.7
计量
- 文章访问数: 2666
- HTML全文浏览量: 85
- PDF下载量: 594
- 被引次数: 0
出版历程
- 出版日期: 2018-04-20

Clinical effect and safety of transarterial chemoembolization combined with apatinib in treatment of advanced primary liver cancer

Department of Gastroenterology, Xijing Hospital, Air Force Medical University

摘要

摘要: 目的比较经肝动脉化疗栓塞术（TACE）联合阿帕替尼与单纯TACE治疗中晚期原发性肝癌（PLC）的临床效果及安全性。方法回顾性分析空军军医大学西京医院2015年3月-2015年8月收治的56例PLC患者的临床资料,按治疗方法不同分为观察组及对照组,每组28例。观察组行TACE联合阿帕替尼治疗,对照组28例行TACE治疗。比较2组治疗后1、3、6、12个月时客观缓解率（ORR）,同时比较2组患者无进展生存期和不良反应发生情况。计量资料2组间比较采用两独立样本t检验。计数资料2组间比较采用χ2检验。中位无进展生存期采用Kaplan-Meier法进行统计分析,同时绘制生存曲线,2组间生存差异分析采用log-rank检验。结果治疗1、3个月时2组ORR差异均无统计学意义（χ2=0.312,P=0.386;χ2=2.450,P=0.118）。治疗6、12个月时2组ORR差异均有统计学意义（χ2=9.458,P=0.002;χ2=13.065,P<0.001）。2组无进展生存期差异有统...
- 肝肿瘤 /
- 化学栓塞,治疗性 /
- 阿帕替尼
Abstract: Objective To investigate the clinical effect and safety of transarterial chemoembolization (TACE) combined with apatinib versus TACE alone in the treatment of advanced primary liver cancer (PLC) .Methods A retrospective analysis was performed for the clinical data of 56 patients with PLC who were admitted to Xijing Hospital of Air Force Medical University from March to August, 2015, and according to therapies, these patients were divided into observation group and control group, with 28 patients in each group.The patients in the observation group were given TACE combined with apatinib, and those in the control group were given TACE alone.The two groups were compared in terms of objective response rate (ORR) at 1, 3, 6, and 12 months after treatment, progression-free survival, and incidence rates of adverse reactions.The two-independent-samples t test was used for comparison of continuous data between groups; the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to analyze median progression-free survival and plot survival curves, and the log-rank test was used for survival difference analysis between the two groups.Results There was no significant difference in ORR at 1 and 3 months after treatment between the two groups (χ2= 0.312 and 2.450, P = 0.386 and 0.118) , while there was a significant difference in ORR at 6 and 12 months after treatment (χ2= 9.458 and 13.065, P = 0.002 and P < 0.001) .There was also a significant difference in progression-free survival between the two groups (χ2= 9.083, P = 0.006) .Compared with the control group, the observation group had significantly higher incidence rates of apatinib-related adverse reactions, such as hypertension, hand-foot syndrome, proteinuria, and diarrhea (χ2= 17.500, 16.095, 15.273, and 5.256, all P < 0.001) , and these adverse reactions were relieved after the symptomatic treatment.Conclusion Compared with TACE alone, TACE combined with apatinib has a better long-term effect and safety in the treatment of advanced PLC.
- liver neoplasms /
- chemoembolization, therapeutic /
- apatinib

HTML全文

参考文献(19)

[1]MITTAL S, EL-SERAQ HB.Epidemiology of hepatocellular carcinoma:cibsider the population[J].J Clin Gastroenterol, 2013, 47 (Suppl) :s2-s6.

[2]LI W, MAN WL, GUO HQ, et al.Clinical research of apatinib with transcatheter arterial chemoembolization in treatment of advanced hepatocellular carcinoma[J].Anti-tumor Pharmacy, 2017, 7 (1) :74-78. (in Chinese) 李威, 满文玲, 郭欢庆.TACE联合甲磺酸阿帕替尼治疗中晚期肝癌的临床研究[J].肿瘤药学, 2017, 7 (1) :74-78.

[3]PENG S, ZHANG Y, PENG H, et al.Intracellular autocrine VEGF signaling promotes EBDC cell proliferation, which can be inhibited by Apatinib[J].Cancer Lett, 2016, 373 (2) :193-202.

[4]QING SK, OUYANG XN, BAI YX, et al.Multicenter phase II study of apatinib, a nover inhibitor of VEGFR, in patients with advanced hepatocellular carcinoma[C].ASCO annual meeting.Chicago, 2014.

[5]CHEN W, ZHENG R, BAADE PD, et al.Cancer statistics in China, 2015[J].CA Cancer J Clin, 2016, 66 (2) :115-132.

[6]HE K, HU ZM, YU YL, et al.Application of precise hepatectomy in primary liver cancer[J/CD].Chin J Hepat Surg:Electronic Edition, 2016, 5 (2) :81-85. (in Chinese) 何坤, 胡泽民, 余元龙, 等.精准肝切除在原发性肝癌中的应用[J/CD].中华肝脏外科手术学电子杂志, 2016, 5 (2) :81-85.

[7]JAYSON GC, KERBEL R, ELLIS LM, et al.Antiangiogenic therapy in oncology:current status and future directions[J].Lancet, 2016, 388 (10043) :518-529.

[8]CHEN J, HOU EC.Progress of VEGF and its receptors in HCC angiogenesis and antiangiogenesis therapy[J].Modern Oncology, 2016, 24 (3) :498-502. (in Chinese) 陈杰, 侯恩存.VEGF及其受体与肝细胞癌血管生成和抗血管治疗研究进展[J].现代肿瘤医学, 2016, 24 (3) :498-502.

[9]JIN XL, LU W.TACE combined with Apatinib in treatment of advanced hepatocellular carcinoma[J].Chin J Interv Ther, 2017, 14 (4) :200-204. (in Chinese) 金鑫荔, 芦伟.TACE联合阿帕替尼治疗中晚期肝细胞癌[J].中国介入影像与治疗学, 2017, 14 (4) :200-204.

[10]KOU P, ZHANG Y, SHAO W, et al.Significant efficacy and well safety of apatinib in an advanced liver cancer patient:a case report and literature review[J].Oncotarget, 2017, 8 (12) :20510-20515.

[11]ZHANG CY, ZHAO XX, LU ZM, et al.Research advances in sorafenib-induced apoptotic signaling pathways in liver cancer cells[J].J Clin Hepatol, 2016, 32 (4) :816-819. (in Chinese) 张朝亚, 赵相轩, 卢再鸣, 等.索拉菲尼诱导肝癌细胞凋亡信号通路的研究进展[J].临床肝胆病杂志, 2016, 32 (4) .816-819.

[12]LI H, LI B.Laparoscopi radiofrequency ablation should be considered a safe treatment for hepatocellular carcinoma patients with severe cirrhosis and impaired IGG-15 test[J].Dig Dis Sci, 2015, 60 (7) :2001-2202.

[13]ITO T, TANAKA S, IWAI S, et al.Outcomes of laparoscopic hepatic resection versus percutaneous radiofrequency ablation for hepatocellular carcinoma located at the liver surface:a case-control study with propensity score matching[J].Hepatol Res, 2016, 46 (6) :565-574.

[14]CHEN BF, PAN CZ, CHEN SX, et al.Clinical efficacy of sorafenib in preventing recurrence of primary liver cancer after radical surgery[J/CD].Chin J Hepat Surg:Electronic Edition, 2016, 5 (1) :38-42. (in Chinese) 陈冰锋, 潘楚芝, 陈署贤, 等.索拉非尼预防原发性肝癌根治性治疗术后复发的临床效果[J/CD].中华肝脏外科手术学电子杂志, 2016, 5 (1) :38-42.

[15]SONG JT, CHEN YG, XU CW, et al.Effect of apatinib on treatment of 53cases of advanced primary liver cancer[J].J Clin Pathol Res, 2017, 37 (3) :557-562. (in Chinese) 宋锦添, 陈奕贵, 许春伟, 等.阿帕替尼治疗53例晚期原发性肝癌的疗效[J].临床与病理杂志, 2017, 37 (3) :557-562.

[16]JIANG ZK, YE XG, CHEN QH.Effect of apatinib on the proliferation and migration of liver cancer cells[J].Chin J Clin Pharmacol, 2016, 32 (15) :1422-1424. (in Chinese) 姜增凯, 叶晓歌, 陈琴华.阿帕替尼对肝癌细胞增殖和迁移能力的影响研究[J].中国临床药理学杂志, 2016, 32 (15) :1422-1424.

[17]TIAN S, QUAN H, XIE C, et al.YN968D1 is a novel and selective inhibitor of vascular endothelial growth factor receptor-2 tyrosine kinase with potent activity in vitro and in vivo[J].Cancer Sci, 2011, 102 (7) :1374-1380.

[18]TU Y, PENG F.Clinical research advances of apatinib in the treatment of malignancies[J].Chin J Clin Oncol, 2016, 43 (12) :545-548. (in Chinese) 涂艳, 彭枫.阿帕替尼治疗恶性肿瘤的临床研究进展[J].中国肿瘤临床, 2016, 43 (12) :545-548.

[19]LIAO JS, LIU Q, LI HJ.Effects and safety of Apatinib mesylate in the treatment of advanced primary liver cancer[J].Hainan Med J, 2017, 28 (5) :714-176. (in Chinese) 廖景升, 刘琦, 黎焕君.甲磺酸阿帕替尼治疗晚期原发性肝癌疗效及安全性观察[J].海南医学, 2017, 28 (5) :714-176.

施引文献

资源附件(0)

访问统计