TACE联合索拉非尼治疗BCLC-C期肝癌的有效性及安全性

目的 观察TACE联合索拉非尼（Sorafenib）治疗巴塞罗那临床肝癌（BCLC）-C期肝细胞癌（HCC）的有效性和安全性。方法 回顾性分析73例BCLC-C期HCC患者，其中35例接受TACE联合索拉菲尼治疗（TACE+Sorafenib组），38例单纯接受TACE治疗（TACE组）。比较2组治疗1个月后的疗效和不良反应，统计总生存期（OS）及疾病进展时间（TTP）。结果 术后1个月，TACE+Sorafenib组疾病控制率（DCR）高于TACE组（P=0.04），2组客观缓解率（ORR）差异无统计学意义（P=0.32）。2组主要不良反应包括胃肠道反应、骨髓抑制、皮肤反应及肝功能异常，均无严重不良反应发生；TACE+Sorafenib组皮肤反应、口腔黏膜炎、高血压发生率高于TACE组（P均<0.05）。TACE+Sorafenib组中位OS为13.6个月，中位TTP为6.5个月，均高于TACE组（分别为6.5、3.3个月，P=0.004、0.007）。结论 TACE联合索拉非尼治疗BCLC-C期HCC安全、有效，可改善患者预后。

Efficacy and safety of TACE combined with Sorafenib in treatment of BCLC-C stage hepatocellular carcinoma

Objective To observe the efficacy and safety of TACE combined with Sorafenib in treatment of Barcelona clinic liver cancer (BCLC)-C stage hepatocellular carcinoma (HCC). Methods Data of 73 patients with BCLC-C stage HCC were analyzed retrospectively. Among them, 35 patients underwent TACE combined with Sorafenib (TACE+Sorafenib group) and 38 underwent TACE alone (TACE group). The therapeutic effect, adverse reactions, overall survival (OS) and time to progression (TTP) of disease 1 month after operation were compared between 2 groups. Results One month after operation, the disease control rate (DCR) in TACE+Sorafenib group was higher than that in TACE group (P=0.04). There was no significant difference of objective response rate (ORR) between groups (P=0.32). The adverse reactions mainly included gastrointestinal reaction, bone marrow suppression, skin reaction and liver function. No serious adverse reaction occurred in both groups. The incidence of skin reaction, oral mucositis and hypertension in TACE+Sorafenib group were higher than those in TACE group (all P<0.05). The median OS and TTP of TACE+Sorafenib group were 13.6 months and 6.5 months, respectively, higher than those in TACE group (6.5 months and 3.3 months, P=0.004, 0.007, respectively). Conclusion TACE combined with Sorafenib was effective and safe for treating BCLC-C stage HCC, which might improve the prognosis.