TACE联合围术期连续服用索拉菲尼治疗中晚期肝细胞癌的安全性探讨

目的探讨经导管肝动脉化疗栓塞术(TACE)联合围术期连续服用索拉菲尼治疗中晚期肝细胞癌(HCC)的安全性。方法选取2017-01-2019-01间收治的220例中晚期HCC患者,根据不同治疗方案分为2组。观察组(58例)采用TACE联合围术期连续服用索拉菲尼治疗,对照组(162例)采用单纯TACE治疗。回顾性分析患者的临床资料。结果 TACE治疗后,2组患者的淋巴细胞、中性粒细胞、血小板、谷丙转氨酶、谷草转氨酶、总胆红素、直接胆红素、白蛋白、凝血酶原时间、肌酐、尿素氮数值及发热、腹痛、上消化道出血和3~4级胃肠道反应发生率差异均无统计学意义(P>0.05)。结论 TACE联合围术期连续服用索拉菲尼治疗中晚期HCC,在达到最佳治疗效果的同时,并不增加不良反应的发生率。因此对TACE联合围术期索拉菲尼治疗的中晚期HCC患者,无需停用索拉菲尼。

Discussion on safety of TACE combined with continuously taking Sorafenib during the perioperative period in treatment of advanced HCC

Objective To investigate the safety of transcatheter arterial chemoembolization(TACE) combined with continuously taking sorafenib during the perioperative period for advanced hepatocellular carcinoma(HCC).Methods Retrospective analysis of 220 patients with advanced HCC admitted to our hospital from January 2017 to January 2019,according to the treatment plan, they were divided into combination therapy(observation group) 58 cases and simple TACE treatment(control group) 162 cases.The control group was treated with TACE alone, and the observation group was treated with TACE combined with continuously taking sorafenib during the perioperative period. The values of lymphocytes, neutrophils, platelets, alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, albumin, prothrombin time, creatinine, urea nitrogen and Grade 3~4 gastrointestinal reaction rate were compared between the two groups after TACE.Results The differences of lymphocytes, neutrophils, platelets, alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, albumin, prothrombin time, creatinine, urea nitrogen values and Grade 3~4 gastrointestinal reaction rate after TACE between both groups there were no statistical significance(all P>0.05).Conclusion TACE combined with continuously taking sorafenib during the perioperative period for the treatment of advanced HCC can theoretically achieve the best therapeutic effect and have higher security, and does not increase the occurrence of adverse reactions. Therefore, patients with advanced HCC who require TACE combined with sorafenib do not need to stop treatment with sorafenib before and after TACE treatment.