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经导管动脉化疗栓塞联合低剂量阿帕替尼治疗老年不可切除肝细胞癌的疗效与安全性

Transcatheter arterial chemoembolization combined with low-dose apatinib in the treatment of unresectable hepatocellular carcinoma in elderly patients: Efficacy and safety.

作者信息

Liu Song, Zhao Guangsheng, Yu Guangji, Guo Nannan, Zhang Yuewei, Li Qiang, Wang Zhe

机构信息

Department of Interventional Therapy, Linyi Cancer Hospital, Linyi; Affiliated provincial hospital, Shandong University School of Clinical Medicine, Jinan, Shandong Province, China.

Hepatobiliary and Pancreatic Center, Beijing Tsinghua Changgeng Hospital, Changping District, Beijing; Department of Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning Province, China.

出版信息

J Cancer Res Ther. 2020 Sep;16(5):1165-1170. doi: 10.4103/jcrt.JCRT_1030_19.

Abstract

CONTEXT

Owing to the increasing age of the population, the incidence of hepatocellular carcinoma (HCC) in the elderly is increasing annually.

AIMS

This study aims to investigate the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with low-dose apatinib for unresectable HCC treatment in elderly patients (≥65 years).

SETTINGS AND DESIGN

The clinical data from 61 elderly patients with unresectable HCC who were retrospectively analyzed.

SUBJECTS AND METHODS

Of these 61 patients, 27 received TACE combined with low-dose (250 mg/qd) apatinib (experimental group), and 34 patients received the standard TACE treatment (control group). The short-term efficacy was evaluated according to the mRECIST1.1 standards, and the mid- and long-term efficacy and safety in the two groups of patients were evaluated.

STATISTICAL ANALYSIS USED

Statistical analyses were performed using the Statistical Package for the Social Sciences software (version 20.0; SPSS).

RESULTS

Both the objective response rate and disease control rate of the experimental group were significantly higher than those of control group (P < 0.05). The 6-month and 12-month survival rates of the experimental group were significantly higher than those of control group too (P < 0.05). The median survival in the experimental group was longer than in the control group (26.0 months vs. 20.0 months). The adverse reactions related to the intake of apatinib were higher in the experimental than the control group, but were generally alleviated after symptomatic treatment.

CONCLUSIONS

TACE combined with low-dose apatinib provides an alternative treatment option for elderly patients with unresectable HCC. Our clinical study has proven its safety and efficacy.

摘要

背景

由于人口老龄化,老年肝细胞癌(HCC)的发病率逐年上升。

目的

本研究旨在探讨经动脉化疗栓塞术(TACE)联合低剂量阿帕替尼治疗老年(≥65岁)不可切除HCC的临床疗效及安全性。

设置与设计

回顾性分析61例老年不可切除HCC患者的临床资料。

研究对象与方法

61例患者中,27例接受TACE联合低剂量(250mg/每日)阿帕替尼治疗(试验组),34例患者接受标准TACE治疗(对照组)。根据mRECIST1.1标准评估短期疗效,并评估两组患者的中长期疗效及安全性。

所用统计分析方法

使用社会科学统计软件包(版本20.0;SPSS)进行统计分析。

结果

试验组的客观缓解率和疾病控制率均显著高于对照组(P<0.05)。试验组的6个月和12个月生存率也显著高于对照组(P<0.05)。试验组的中位生存期长于对照组(26.0个月对20.0个月)。试验组与阿帕替尼摄入相关的不良反应高于对照组,但经对症治疗后一般可缓解。

结论

TACE联合低剂量阿帕替尼为老年不可切除HCC患者提供了一种替代治疗选择。我们的临床研究证明了其安全性和有效性。

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