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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
Clinical effect and safety of transarterial chemoembolization combined with apatinib in treatment of advanced primary liver cancer
文章发布日期:2018年03月07日  来源:  作者:武健,尹芳,罗贯虹,等  点击次数:685次  下载次数:123次

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【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计学意义(χ2=9083,P=0.006)。观察组高血压、手足综合征、蛋白尿、腹泻等阿帕替尼相关不良反应发生率显著高于对照组,差异均有统计学意义(χ2值分别为17.500、16.095、15.273、5.256,P值均<0.001)。不良反应经对症处理较前缓解。结论与单纯TACE治疗相比,TACE联合阿帕替尼对于治疗中晚期PLC有更好的中远期疗效,且有一定的安全性。
【Abstract】:ObjectiveTo 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). MethodsA 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. ResultsThere 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. ConclusionCompared with TACE alone, TACE combined with apatinib has a better long-term effect and safety in the treatment of advanced PLC.
【关键字】:肝肿瘤;化学栓塞, 治疗性; 阿帕替尼
【Key words】:liver neoplasms; chemoembolization, therapeutic; apatinib
【引证本文】:WU J, YIN F, LUO GH, et al. Clinical effect and safety of transarterial chemoembolization combined with apatinib in treatment of advanced primary liver cancer[J]. J Clin Hepatol, 2018, 34(4): 775-778. (in Chinese)
武健, 尹芳, 罗贯虹,等. 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[J]. 临床肝胆病杂志, 2018, 34(4): 775-778.

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