肝动脉化疗栓塞联合索拉菲尼治疗中晚期肝细胞癌

目的 探讨肝动脉化疗栓塞（TACE）联合索拉菲尼治疗中晚期肝细胞癌（HCC）的临床价值。方法 前瞻性分析我院2011年1月至2012年1月接受TACE联合索拉菲尼（n=27）和TACE单独治疗（n=25）的中晚期HCC患者的临床资料，比较两组患者肿瘤中位进展时间、肿瘤无进展生存率和总生存率。结果 随访期间，联合治疗组共发生肿瘤进展18例，死亡10例，疾病控制率为74.1%；TACE单独治疗组共发生肿瘤进展19例，死亡15例，疾病控制率为68.0%。联合治疗组和TACE单独治疗组肿瘤中位进展时间分别为6.5个月和3.3个月（P＜0.05），两组6和12个月的肿瘤无进展生存率分别为51.9%、33.3%和27.6%、16.5%（P＜0.05），总生存率分别为81.0%、60.8%和63.3%、34.8%（P＜0.05）。联合治疗组的手足皮肤反应、口腔黏膜炎发生率较TACE单独治疗组高（P＜0.05），药物减量辅以对症治疗后控制良好。结论 TACE联合索拉菲尼治疗中晚期HCC是安全有效的，优于TACE单独治疗，值得临床进一步验证推广。

Combination of transarterial chemoembolization with sorafenib in patients with unresectable hepatocellular carcinoma

Objective To evaluate the clinical value of combination of transarterial chemoembolization (TACE) with sorafenib in the treatment of patients with advanced hepatocellular carcinoma (HCC). Methods Between Jan. 2011 and Jan. 2012, patients with advanced HCC were enrolled for this prospective analysis. 27 patients were administrated TACE plus sorafenib, while 25 patients only received TACE. The median time to tumor progression, progression-free survival and overall survival rates were compared. Results During the follow-up, 18 patients in the combined therapy group had tumor progression and 10 died, the disease control rate was 74.1%, while 19 patients in the TACE group had tumor progression and 15 died, the disease control rate was 68.0%. The median time to tumor progression was 6.5 months and 3.3 months (P<0.05) in combined therapy group and TACE group, respectively. The 6- and 12-month progression-free survival rates in combined therapy group and TACE group were 51.9%, 33.3% and 27.6%, 16.5%, respectively (P<0.05). The 6- and 12-month patient overall survival rates in combined therapy group and TACE group were 81.0%, 60.8% and 63.3%, 34.8% (P<0.05). The incidences of hand-foot syndrome and oral mucositis in combined therapy group were significantly higher than those in TACE group (P<0.05). However, they could be controlled by dose reduction and symptomatic treatment. Conclusion Treatment of TACE combined with sorafenib is safe and effective for patients with advanced HCC, and it is superior for TACE monotherapy, which worth further clinical study.