TACE术后阿帕替尼维持治疗进展期肝细胞癌患者疗效分析

目的 研究经导管肝动脉化疗栓塞术(TACE)后应用阿帕替尼维持治疗进展期肝细胞癌(HCC)患者的疗效及其影响因素.方法 2018年1月～2019年12月我院收治的138例进展期HCC患者,采用TACE治疗后给予阿帕替尼维持治疗2～3个疗程.采用化学发光免疫分析法检测血清甲胎蛋白(AFP)水平,采用ELISA法检测血浆热...

Impacting efficacy factors of apatinib maintaining treatment after transcatheter hepatic artery chemoembolization in patients with advanced hepatocellular carcinoma

Objective This study aimed to investigate the impacting efficacy factors of apatinib maintaining treatment after transcatheter hepatic artery chemoembolization (TACE) in patients with advanced hepatocellular carcinoma (HCC). Methods 138 patients with advanced HCC were recruited in our hospital between January 2018 and December 2019, and all patients received apatinib maintenance therapy after TACE for 2 to 3 courses of treatment. Serum alpha fetoprotein (AFP) level was detected by chemiluminescence immunoassay and plasma level of heat shock protein 90 α (Hsp90 α) was measured by ELISA. The impacting efficacy factors were analyzed by multivariate Logistic regression analysis. Results At the end of the treatment, 10 patients (7.2%) obtained complete response, 56 patients (40.6%) obtained partial response, 42 patients (30.4%) got stable disease, and 30 patients (21.7%) got progressive disease; the proportions of age older than 60 years, Child-Pugh class B, BCLC stage C, tumor diameter greater than 5 cm, serum AFP level greater than 400.0 U/L and HSP90 level greater than 460.0 ng/mL in patients with progressive disease were 57.4%, 55.2%, 53.2%, 55.3%, 62.5% and 65.7%, allsignificantly higher than 42.6%, 44.8%, 46.8%, 44.7%, 37.5% and 34.3% in the disease controlled group (P<0.05); the multivariate Logistic regression analysis showed that Child-Pugh classification, BCLC stage, serum AFP and HSP90 were the independent factors influencing the clinical efficacy of apatinib after TACE in patients with advanced HCC (P<0.05). Conclusion The apatinib maintenance therapy after TACE in the treatment of patients with advanced HCC has to some extent short-term efficacy, however, the clinicians should take some influencing efficacy factors into consideration, and select the eligible patients for treatment.