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经动脉化疗栓塞联合治疗对接受索拉非尼治疗的晚期肝细胞癌患者总生存期的影响。

The Impact of Combined Transarterial Chemoembolization on the Overall Survival of Patients with Advanced Hepatocellular Carcinoma Treated with Sorafenib.

作者信息

Chen Lufeng, Su Hongying, Shao Haibo, Xu Ke, Liang Songnian, Liu Jing

出版信息

Hepatogastroenterology. 2014 May;61(131):802-8.

Abstract

BACKGROUND/AIMS: Sorafenib has been proved to prolong survival of patients with advanced hepatocellular carcinoma (HCC), but with moderate efficacy. The present study aimed to evaluate the prognostic factors for overall survival (OS) in Chinese patients with advanced HCC treated with sorafenib who had been refractory to transarterial chemoembolization (TACE) and identify the impact of combined TACE on OS.

METHODOLOGY

29 cases with advanced HCC treated with sorafenib between Feb 2009 and Sep 2012 who had been treated with TACE and finally failed to respond to TACE were included in the analysis. The survival was analysed by Kaplan-Meier Method. The clinical parameters were analysed by univariate and multivariate analysis to determine the prognostic factors of OS.

RESULTS

Median OS of the whole cohort was 11.867 months. Combined TACE and ALB > 39.4 g/L were the independent prognostic factors associated with improved OS while Barcelona Clinic Liver Cancer (BCLC) stage C was associated with reduced OS. The overall incidence of sorafenib-related adverse effects was 82.8% and most were mild.

CONCLUSION

Albumin and combined TACE is associated with improved OS in patients with advanced HCC treated with sorafenib who had been refractory to TACE. While, BCLC stage C is an independent negative prognostic factor for the OS.

摘要

背景/目的:索拉非尼已被证明可延长晚期肝细胞癌(HCC)患者的生存期,但疗效中等。本研究旨在评估经动脉化疗栓塞术(TACE)难治的接受索拉非尼治疗的中国晚期HCC患者的总生存期(OS)的预后因素,并确定联合TACE对OS的影响。

方法

分析2009年2月至2012年9月间29例接受索拉非尼治疗的晚期HCC患者,这些患者均接受过TACE治疗且最终对TACE无反应。采用Kaplan-Meier法分析生存期。通过单因素和多因素分析临床参数以确定OS的预后因素。

结果

整个队列中位OS为11.867个月。联合TACE和白蛋白>39.4 g/L是与OS改善相关的独立预后因素,而巴塞罗那临床肝癌(BCLC)分期C与OS降低相关。索拉非尼相关不良反应的总发生率为82.8%,且大多数为轻度。

结论

白蛋白和联合TACE与接受索拉非尼治疗且对TACE难治的晚期HCC患者的OS改善相关。而BCLC分期C是OS的独立负性预后因素。

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