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经动脉化疗栓塞联合阿帕替尼治疗晚期肝细胞癌:生存和预后因素分析。

Transarterial Chemoembolization Combined with Apatinib for Treatment of Advanced Hepatocellular Carcinoma: Analysis of Survival and Prognostic Factors.

机构信息

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.

出版信息

Curr Med Sci. 2022 Oct;42(5):1015-1021. doi: 10.1007/s11596-022-2620-6. Epub 2022 Sep 3.

Abstract

OBJECTIVE

Apatinib is a novel inhibitor of vascular endothelial growth factor receptor-2. The goal of this study was to evaluate overall survival (OS) after a combination of transarterial chemoembolization (TACE) and apatinib in patients with advanced hepatocellular carcinoma (HCC) and to identify the factors affecting patient survival.

METHODS

Fifty-one patients with advanced HCC who received TACE in combination with apatinib in our hospital from June 2015 to May 2017 were enrolled. The OS and progression-free survival (PFS) were calculated using the Kaplan-Meier method. The log-rank test and Cox regression model were used to determine the factors affecting OS.

RESULTS

The median OS and PFS of the patients were 15 months and 10 months, respectively. The 1-, 2-, and 3-year survival rates were 64.7%, 23.5%, and 1.8%, respectively. Univariate survival analysis showed that patients with Child-Pugh A (P=0.006), reduction rate of proper hepatic artery (P=0.016), hand-foot syndrome (P=0.005), secondary hypertension (P=0.050), and without ascites (P=0.010) had a better OS. Multivariate analysis showed that hand-foot syndrome (P=0.014), secondary hypertension (P=0.017), and reduction rate of proper hepatic artery (P=0.025) were independent predictors of better OS.

CONCLUSION

TACE combined with apatinib is a promising treatment for advanced HCC. Hand-foot syndrome, secondary hypertension, and the reduction rate of proper hepatic artery were associated with a better OS.

摘要

目的

阿帕替尼是一种新型血管内皮生长因子受体-2抑制剂。本研究旨在评估中晚期肝细胞癌(HCC)患者接受经动脉化疗栓塞(TACE)联合阿帕替尼治疗后的总生存期(OS),并确定影响患者生存的因素。

方法

本研究纳入 2015 年 6 月至 2017 年 5 月在我院接受 TACE 联合阿帕替尼治疗的 51 例中晚期 HCC 患者。采用 Kaplan-Meier 法计算 OS 和无进展生存期(PFS)。采用对数秩检验和 Cox 回归模型确定影响 OS 的因素。

结果

患者的中位 OS 和 PFS 分别为 15 个月和 10 个月。1、2、3 年生存率分别为 64.7%、23.5%和 1.8%。单因素生存分析显示,Child-Pugh A 分级(P=0.006)、肝固有动脉减少率(P=0.016)、手足综合征(P=0.005)、继发性高血压(P=0.050)和无腹水(P=0.010)患者的 OS 更好。多因素分析显示,手足综合征(P=0.014)、继发性高血压(P=0.017)和肝固有动脉减少率(P=0.025)是 OS 更好的独立预测因素。

结论

TACE 联合阿帕替尼是治疗中晚期 HCC 的一种有前途的方法。手足综合征、继发性高血压和肝固有动脉减少率与 OS 改善相关。

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