索拉非尼治疗19例晚期原发性肝癌临床疗效观察

目的：观察索托非尼治疗19例晚期原发性肝癌患者的疗效及不良反应。方法19例无法手术切除的晚期原发性肝癌患者口服索拉非尼400 mg,2次/d,至出现不可耐受的不良反应或连续两次评价为疾病进展时停药,观察疗效和不良反应。结果在服药后3个月观察,获得 PR 1例（5.3%）,SD 10例（52.6%）,PD8例（42.1%）,42.9%（6/14）患者 AFP 明显降低,而50.0%（7/14）呈不同程度的增加;随访3～22（8.5）个月,16例（84.2％）患者死亡,3例（16％）患者仍继续服药,中位疾病进展时间（TTP）为5.1个月（1.5～15.0个月）,中位总生存期（OS）为6.5个月（3.0-22.0个月）;16例（84.2％）患者出现手足皮肤硬化、麻木,7例（36.8%）出现皮疹和脱发,10例（52.6%）血压升高,15例（78.9%）发生胃肠道不良反应,2例（10.5%）发生骨髓抑制,8例（42.1%）出现腹泻。结论索拉非尼治疗晚期原发性肝癌患者有一定的疗效,多数不良反应可以耐受,服药期间患者的生活质量保持稳定。

Clinical observation of sorafenib in the treatment of nineteen patients with advanced primary liver can-cer

Objective To observe the efficacy of sorafenib in the treatment of advanced primary liver can-cer. Methods Nineteen patients with advanced primary liver cancer were treated by sorafenib at a dose of 400mg twice daily until the occurrence of intolerable toxicity or death. Results Partial response was obtained in one （5.3%）,stable disease in 10 （52.6%）,and progressed disease in 8 （42.1%）,and serum alpha fetoprotein de-creased in 42.9%（6/14）of patients three months after the regimen;sixteen patients（84.2%） died,and three survived still taking sorafenib at eight month follow-up; sixteen （84.2%）got hand and foot numb,seven （36.8%）got rash and alopecia,ten had blood hypertension, fifteen （78.9%）had gastrointestinal symptoms,two （10.5%） went arrest of bone marrow,and eight （42.1%）had diarrhea. Conclusion Sorafenib is effective and safe in treatment of pa-tients with advanced primary liver cancer. The quality of life in those patients is stable during the administration of sorafenib.