TACE联合阿帕替尼治疗中晚期肝细胞癌无进展生存时间的影响因素分析

目的探讨可能影响肝动脉化疗栓塞(TACE)联合阿帕替尼治疗中晚期肝细胞癌(HCC)患者无进展生存时间(PFS)的因素。方法回顾性分析2016年1至3月收治的32例用TACE联合阿帕替尼治疗的中晚期HCC患者。记录每例患者的疾病无进展生存期(PFS),并对所有可能影响患者PFS的因素进行分析。使用SPSS 17.0统计软件进行统计分析,以P<0.05表示差异有统计学意义。结果本研究患者的中位PFS(mPFS)是14个月;BCLC B期患者mPFS为18个月,而BCLC C期患者为8个月;治疗前AFP<400 ng/mL患者mPFS为16个月,而治疗前AFP≥400 ng/mL患者为11个月;高血压患者m PFS为18个月,无高血压患者为10个月;蛋白尿患者m PFS为19个月,而无蛋白尿患者为12个月;伴手足综合征患者m PFS为16个月,而无手足综合征患者为9个月,以上差异均有统计学意义(P<0.05)。结论BCLC分期、治疗前AFP水平以及高血压、蛋白尿、手足综合征的发生情况是TACE联合阿帕替尼治疗中晚期HCC患者PFS的影响因素,且BCLC分期和高血压的发生情况是影响患者PFS的独立预后因素。

Analysis of influencing factors of progression-free survival in patients with advanced HCC treated with TACE combined with apatinib

Objective To investigate the factors that may influence progression-free survival(PFS)in patients with advanced hepatocellular carcinoma(HCC)who were treated with transcatheter arterial chemoembolization(TACE)combined with apatinib.Methods The clinical data of a total of 32 patients with advanced HCC,who received TACE combined with apatinib therapy during the period from January 2016 to March 2016 at the First Affiliated Hospital of Kunming Medical University of China,were retrospectively analyzed.The PFS of each patient was recorded,and all factors that might affect the PFS of patients were analyzed.The statistical software SPSS 17.0 was used to make statistical analysis,and P<0.05 indicated a statistically significant difference.Results The median PFS(mPFS)in this series was 14 months.The mPFS was 18 months in patients with BCLC stage B and 8 months in patients with BCLC stage C.In patients whose preoperative AFP was<400 ng/mL the mPFS was 16 months,while in patients whose preoperative AFP was≥400 ng/mL the mPFS was 11 months.In patients with hypertension the mPFS was 18 months and in patients with neither hypertension nor proteinuria the mPFS was 10 months.In patients with proteinuria the mPFS was 19 months and in patients with neither hypertension nor proteinuria the mPFS was 12 months.In patients with hand-foot syndrome the mPFS was 16 months and in patients with no handfoot syndrome the mPFS was 9 months.The differences in the above mentioned items were statistically significant(P<0.05).Conclusion The BCLC stage,pre-treatment AFP levels,hypertension,proteinuria and hand-foot syndrome are the factors that affect the PFS of patients with advanced HCC who are treated with TACE combined with apatinib.BCLC stage and hypertension are independent prognostic factors.