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目的:评价索拉非尼治疗进展期肝细胞癌(HCC)的疗效及分析其预后影响因素方法:前瞻性分析2007年8月至2009年7月间110例接受索拉非治疗的进展期HCC患者,评价其疗效、不良反应,以总生存期和无肿瘤进展生存期为预后指标进行单因素和Cox比例风险模型多因素分析。结果:110例患者随访中位时间9(2～18)个月,服用索拉非尼中位时间6.5(2～18)个月14例(12.7%)获得完全缓解(CR),16例(14.5%)部分缓解(PR),40例(36.4%)病情稳定(SD),总有效率为70例(63.6%)。中位生存期和无肿瘤进展生存期分别为10.5个月(95%CI:8.7～12-3)和5.0个月(95%CI:3.7～63)。多因素分析显示:联合局部治疗(肝动脉化疗栓塞或氩氦刀)、美国东部肿瘤协作组活动状态评分(Eastern Cooperative OncologyGroup performanee slatus score,ECOG PS)和Child-Pugh分级是影响无肿瘤进展生存时间的独立预后因素,而联合局部治疗、ECOG PS评分和AFP(alfa-fetopro-lein)水平是影响总生存期的独立预后因素。亚组分析显示:在肝癌进展组患者中继续服用索拉非尼其总生存期明显长于终止索拉非尼治疗者(11个月vs.7.5个月,P<0.001)。结论:索拉非尼治疗进展期HCC,ECOG PS评分是影响生存期的一个重要因素,联合局部治疗有益于改善生存期
Objective: To evaluate the efficacy of sorafenib in the treatment of advanced hepatocellular carcinoma (HCC) and analyze its prognostic factors. METHODS: A prospective analysis of 110 patients with advanced HCC treated with sorafenib from August 2007 to July 2009 Patients were evaluated for their efficacy and adverse reactions. Multivariate analysis was performed using single-factor and Cox proportional hazards models for overall survival and progression-free survival as predictors of prognosis. Results: The median follow-up time was 9 (2-18) months in 110 patients, complete remission (CR) in 14 (12.7%) patients with median seizure time 6.5 (2-18) 14.5%) partial response (PR), 40 cases (36.4%) stable condition (SD), the total effective rate was 70 cases (63.6%). The median survival and tumor-free survival were 10.5 months (95% CI 8.7 to 12-3) and 5.0 months (95% CI 3.7 to 63), respectively. Multivariate analysis showed that Eastern Cooperative Oncology Group performanee slatus score (ECOG PS) and Child-Pugh classification were significantly associated with progression-free survival with tumor progression (hepatic artery chemoembolization or argon-helium knife) Of the independent prognostic factors, while the combination of local treatment, ECOG PS score and AFP (alfa-fetoprolein) levels are independent prognostic factors affect the overall survival. Subgroup analyzes showed that the overall survival of patients receiving advanced hepatocellular carcinoma was significantly longer than that of patients who discontinued sorafenib (11 months vs. 7.5 months, P <0.001). Conclusion: Sorafenib treatment of advanced HCC, ECOG PS score is an important factor affecting survival, combined with local treatment is beneficial to improve survival