索拉菲尼联合肝动脉栓塞化疗和氩氦刀消融治疗晚期肝癌的效果观察

目的：对比索拉菲尼单药与联合应用肝动脉栓塞化疗术（ TACE）、经皮局部氩氦刀消融（PLCT）综合治疗失去手术机会的肝癌的治疗效果。方法回顾性分析64例无法手术切除的肝癌患者的临床资料，行索拉菲尼单药或索拉菲尼联合 TACE、PLCT 治疗。其中索拉菲尼单药治疗32例，联合介入和氩氦刀消融治疗32例，随访时间6～32个月，观察两组患者治疗效果和肿瘤进展时间。结果所有患者顺利完成治疗，无手术相关死亡及严重并发症。64例患者中，完全缓解（ CR）11例，部分缓解（PR）31例，稳定（SD）14例，进展（PD）8例，其中单药治疗组 CR 3例，PR 11例，SD 12例，PD 6例；联合介入和氩氦刀消融组 CR 8例，PR 20例，SD 2例，PD 2例，两组比较差异有统计学意义（χ^2=14.028，P=0.003）。中位肿瘤进展时间分别为20周和53周，两组比较差异有统计学意义（χ^2=14.773，P=0.000）。结论针对无法手术切除的肝癌，索拉菲尼联合 TACE 和 PLCT 治疗效果较好，可延长肿瘤进展时间。

Effect of sorafenib combined with transarterial chemoembolization and percutaneous local cryotherapy on treating advanced hepatocellular carcinoma

Objective To investigate the efficacy of sorafenib alone or combination with transarterial chemoembolization（TACE）and percutaneous local cryotherapy（PLCT）for advanced hepatocellular carcinoma patients without operation opportunity. Methods Sixty-four advanced hepatocellular carcinoma patients were selected as our subjects,who were underwent treatment of sorafenib alone or combination with TACE and PLCT. Thirty-two cases with sorafenib therapy were served as sorafenib group and another 32 cases with sorafenib in combination with transarterial chemoembolization and PLCT were served as combination group. All patients were followed up for 6 - 32 months. The treatment efficacy and tumor development were recorded. Results All surgeries of the patients were succeed and no death or serious operation complications occurred. Of 64 patients, 11 were achieved a complete remission（ CR）,31 cases with partial remission（ PR）,14 cases with stable development（SD）,and 8 cases with progressive disease（PD）. In the sorafenib group,3 cases were with CR,11 patients with PR,12 with SD,and 6 patients with PD. In the combination group,8 patients were with CR,20 patients with PR,2 patients with SD and 2 patients with PD,and the difference was significant between the two groups（χ^2 = 14. 028,P = 0. 003）. The median periods to tumor progression were 20 and 53 weeks in the sorafenib group and the combination group,and the difference was significant（ χ^2 = 14. 773,P = 0. 000）. Conclusion For hepatocellular carcinoma patients without operation opportunity,sorafenib combined with TACE and PLCT can increase the tumor remission rate and prolong the periods to tumor progression in patients with hepatocellular carcinoma.