索拉非尼联合经导管肝动脉化疗栓塞治疗无远处转移的晚期肝细胞癌

目的　观察多靶点分子靶向治疗药物索拉非尼联合经导管肝动脉化疗栓塞（ＴＡＣＥ）治疗不伴远处转移的晚期或进展期肝细胞癌的疗效和不良反应。方法　２００７年４月至２００９年９月，中国医学科学院肿瘤医院收治４５例不伴有远处转移的晚期或进展期肝细胞癌患者，口服索拉非尼治疗，其中１８例联合ＴＡＣＥ（１～５次），２７例单用索拉非尼。索拉非尼起始剂量４００ｍｇ，每日２次，治疗过程中根据不良反应发生情况调整用量。每２个月评价疗效和不良反应，并随访中位至疾病进展时间（ＴＴＰ）和中位总生存时间（ＯＳ）。结果　至２００９年１２月，４０例患者达到临床评价要求（联合ＴＡＣＥ１８例，单用索拉非尼２２例）。两组不良反应发生率无显著差异，主要治疗相关不良反应为手足皮肤反应、腹泻和高血压。两组患者均无４级严重不良反应。索拉非尼联合ＴＡＣＥ组中位ＴＴＰ为１０.０个月，中位ＯＳ１６.０个月；单用索拉非尼组中位ＴＴＰ为４.５个月，中位ＯＳ５.３个月。两组ＯＳ和ＴＴＰ差异有统计学意义（Ｐ＜０.０１）。结论　病变局限在肝内且不合并远处转移的晚期或进展期肝细胞癌患者，口服索拉非尼联合ＴＡＣＥ不增加并发症发生率，且生存预后改善。

Clinical observation of sorafenib together with TACE in advanced hepatocellular carcinoma with no extrahepatic metastasis

Objective To evaluate the efficacy and safety of molecular targeted agent sorafenib together with TACE in advanced hepatocellular carcinoma without extrahepatic metastasis.Methods From Apr.2007,to Sep.2009,45 advanced hepatocelluar carcinoma patients without extrahepatic metastasis were orally treated with sorafenib at a dose of 400 mg twice daily.Among them,18 patients were treated with TACE(1-5times).Results The most common adverse events in both groups were hand foot skin reaction,diarrhea and hypertensi...