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目的评价经导管肝动脉化疗栓塞术(TACE)联合索拉非尼治疗肝细胞肝癌的疗效和安全性。方法入选57例原发性肝细胞肝癌患者,其中23例行TACE联合索拉菲尼治疗(试验组),34例行单纯TACE治疗(对照组),对照组用阿霉素类药物20~40 mg化疗,超液化碘油剂量5~20 m L。如果患者需要进行多次TACE治疗,每次TACE治疗的时间间隔约为45 d。试验组在对照组基础上,第1次TACE治疗后72 h内口服索拉非尼400 mg,早、晚各服1次,连续服药,直至药品不良反应不能耐受或疾病进展。比较2组疗效、生存状况和不良反应。结果试验组近期疗效优于对照组(P<0.05)。试验组中位生存期为14.9个月,高于对照组的8.7个月(P>0.05)。试验组患者腹泻、手足综合征、皮疹的发生率均高于对照组(P<0.05);2组患者消化道反应、骨髓抑制、肝功能异常的发生率差异均无统汁学意义(P>0.05)。结论 TACE联合索拉非尼治疗肝细胞肝癌能延长患者生存期,且安全性与耐受性较好。
Objective To evaluate the efficacy and safety of transcatheter hepatic arterial chemoembolization (TACE) combined with sorafenib in the treatment of hepatocellular carcinoma. Methods Fifty-seven patients with primary hepatocellular carcinoma were enrolled. TACE combined with sorafenib was used in 23 patients (experimental group) and TACE alone in 34 patients (control group). The control group was treated with doxorubicin 20 ~ 40 mg chemotherapy, ultra-liquefied iodine dose of 5 ~ 20 m L. If the patient needs multiple TACE treatments, the time interval between TACE treatments is approximately 45 days. On the basis of the control group, the experimental group was given oral Sorafenib 400 mg within 72 hours after the first TACE treatment, taking each morning and evening one time, taking the medicine continuously until the adverse drug reaction can not be tolerated or the disease progresses. The efficacy, survival status and adverse reactions of the two groups were compared. Results The curative effect of the experimental group was better than that of the control group (P <0.05). The median survival time of the experimental group was 14.9 months, which was higher than that of the control group for 8.7 months (P> 0.05). The incidence of diarrhea, hand-foot syndrome and rash in the experimental group were higher than those in the control group (P <0.05). There was no significant difference in the incidence of digestive tract reactions, bone marrow suppression and liver dysfunction between the two groups (P> 0.05). Conclusion TACE combined with sorafenib treatment of hepatocellular carcinoma can prolong the survival of patients with good safety and tolerability.