[1]章浙伟,郑家平,郭立文,等.TACE联合瑞戈非尼序贯治疗中晚期肝细胞癌的疗效和安全性[J].介入放射学杂志,2022,31(12):1198-1202.
 ZHANG Zhewei,ZHENG Jiaping,GUO Liwen,et al.Clinical efficacy and safety of TACE combined with regorafenib sequential treatment for mid-advanced hepatocellular carcinoma China[J].journal interventional radiology,2022,31(12):1198-1202.
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TACE联合瑞戈非尼序贯治疗中晚期肝细胞癌的疗效和安全性()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
31
期数:
2022年12
页码:
1198-1202
栏目:
临床研究
出版日期:
2023-01-11

文章信息/Info

Title:
Clinical efficacy and safety of TACE combined with regorafenib sequential treatment for mid-advanced hepatocellular carcinoma China
作者:
章浙伟 郑家平 郭立文 郝伟远 曾 晖 罗 君 邵国良
Author(s):
ZHANG Zhewei ZHENG Jiaping GUO Liwen HAO Weiyuan ZENG Hui LUO Jun SHAO Guoliang.
Department of Interventional Therapy, Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital), Hangzhou, Zhejiang Province 310022,
关键词:
【关键词】 肝细胞癌 瑞戈非尼 肝动脉化疗栓塞术 安全性 临床疗效
文献标志码:
A
摘要:
【摘要】 目的 评估TACE联合瑞戈非尼二线序贯治疗中晚期肝细胞癌(HCC)的临床疗效和安全性。方法 纳入2018年6月至2019年12月中国科学院大学附属肿瘤医院收治的中晚期HCC患者60例。患者均接受TACE联合索拉非尼一线靶向治疗,因疾病进展或无法耐受索拉非尼,口服瑞戈非尼二线序贯治疗。按mRECIST标准评价疗效,并观察患者的疾病进展时间和总生存期(OS),服药期间记录不良反应的发生。结果 随访至2021年6月,60例患者中,存活38例,死亡12例,失访10例,客观有效率(ORR)为3.3%,疾病控制率(DCR)为56.6%,中位疾病进展时间(mTTP)为3.5个月(95%CI:2.9~4.1个月),中位总生存期(mOS)为11.3个月(95%CI:9.8~12.8个月),1年生存率为76%。TACE联合瑞戈非尼的不良反应有手足皮肤反应35例(58.3%),口腔黏膜炎18例(30%),疲乏16例(26.7%),腹泻22例(36.7%),高血压7例(11.7%),肝功能异常28例(46.7%),蛋白尿4例(6.7%),血小板减少27例(45%),中性粒细胞减少16例(26.7%),贫血32例(53.3%)等。结论 TACE联合瑞戈非尼二线序贯治疗中晚期HCC安全有效,对于索拉非尼治疗进展或无法耐受患者,联合序贯治疗可改善疾病进展时间和OS,且不良反应1~2级多见,绝大部分患者可耐受。

参考文献/References:

[1] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018[J]. CA Cancer J Clin, 2018, 68: 7-30.
[2] Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71: 209-249.
[3] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66: 115-132.
[4] Zuo MX, Huang JH. The history of interventional therapy for liver cancer in China[J]. J Interv Med, 2018, 1: 70-76.
[5] Sergio A, Cristofori C, Cardin R, et al. Transcatheter arterial chemoembolization(TACE) in hepatocellular carcinoma (HCC): the role of angiogenesis and invasiveness[J]. Am J Gastroenterol, 2008, 103: 914-921.
[6] 余晨曦,滕皋军. 经导管动脉化疗栓塞术抵抗研究进展[J]. 介入放射学杂志, 2017, 26:1063-1067.
[7] Liu K, Min XL, Peng J, et al. The changes of HIF-1α and VEGF expression after TACE in patients with hepatocellular carcinoma[J]. J Clin Med Res, 2016, 8: 297-302.
[8] Kudo M,Han KH,Ye SL,et al. A changing paradigm for the treatment of intermediate- stage hepatocellular carcinoma: Asia-Pacific Primary Liver Cancer Expert Consensus Statements[J]. Liver Cancer, 2020, 9: 245-260.
[9] Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma[J]. N Engl J Med, 2008, 359: 378-390.
[10] Personeni N, Pressiani T,Santoro A,et al. Regorafenib in hepato-cellular carcinoma: latest evidence and clinical implications[J]. Drugs Context, 2018, 7: 212533.
[11] Kudo M, Ueshima K, Ikeda M, et al. Randomised, multicentre prospective trial of transarterial chemoembolisation(TACE) plus sorafenib as compared with TACE alone in patients with hepato-cellular carcinoma:TACTICS trial[J]. Gut, 2020, 69: 1492-1501.
[12] 中华人民共和国卫生和计划生育委员会医政医管局. 原发性肝癌诊疗规范(2017年版)[J]. 中华消化外科杂志, 2017, 16:635- 647.
[13] Wen T, Jin C, Facciorusso A, et al. Multidisciplinary management of recurrent and metastatic hepatocellular carcinoma after resection: an international expert consensus[J]. Hepatobiliary Surg Nutr, 2018, 7: 353-371.
[14] Park JW,Chen M,Colombo M,et al. Global patterns of hepato-cellular carcinoma management from diagnosis to death: the BRIDGE Study[J]. Liver Int, 2015, 35: 2155-2166.
[15] Wei G, Yang J. Advances in the treatment of hepatocellular carcinoma using drug- eluting beads[J]. J Interv Med, 2020, 3: 122-127.
[16] Lencioni R,de Baere T,Soulen MC,et al. Lipiodol transarterial chemoembolization for hepatocellular carcinoma: a systematic review of efficacy and safety data[J]. Hepatology, 2016, 64: 106-116.
[17] Idee JM, Guiu B. Use of lipiodol as a drug- delivery system for transcatheter arterial chemoembolization of hepatocellular carci-noma: a review[J]. Crit Rev Oncol Hematol, 2013, 88: 530-549.
[18] Park JW,Amarapurkar D,Chao Y,et al. Consensus recommen-dations and review by an International Expert Panel on Interventions in Hepatocellular Carcinoma(EPOIHCC)[J]. Liver Int, 2013, 33: 327-337.
[19] 陈晓明,程永德. 中期肝癌TACE之争论与研究现状[J]. 介入放射学杂志, 2021, 30:751-755.
[20] Heo YA, Syed YY. Regorafenib: a review in hepatocellular carcinoma[J]. Drugs, 2018, 78: 951- 958.
[21] Bruix J, Qin S, Merle P, et al. Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): a randomised, double-blind, placebo- controlled, phase 3 trial[J]. Lancet, 2017, 389: 56-66.
[22] Wilhelm SM, Carter C, Tang L, et al. BAY 43- 9006 exhibits broad spectrum oral antitumor activity and targets the RAF/MEK/ERK pathway and receptor tyrosine kinases involved in tumor progression and angiogenesis[J]. Cancer Res, 2004, 64: 7099-7109.
[23] Wilhelm SM, Dumas J, Adnane L, et al. Regorafenib(BAY 73-4506): a new oral multikinase inhibitor of angiogenic, stromal and oncogenic receptor tyrosine kinases with potent preclinical antitumor activity[J]. Int J Cancer, 2011, 129: 245-255.
[24] Strebel BM, Dufour JF. Combined approach to hepatocellular carcinoma: a new treatment concept for nonresectable disease[J]. Expert Rev Anticancer Ther, 2008, 8: 1743-1749.
[25] 张璐西,施海彬,刘 圣,等. TACE联合索拉非尼治疗BCLC-C期肝细胞癌20例疗效分析[J].介入放射学杂志, 2014, 23:954-958.
[26] 魏照光,陆骊工,邵培坚,等. 肝动脉化疗栓塞联合索拉非尼治疗中晚期肝细胞癌的临床疗效观察[J].中华放射学杂志,2012, 46:252-256.
[27] 姚雪松,闫 东,曾辉英,等. TACE联合索拉非尼治疗不能手术切除肝细胞肝癌50例[J]. 介入放射学杂志, 2013, 22:381-386.
[28] Kudo M. Regorafenib as second- line systemic therapy may change the treatment strategy and management paradigm for hepatocellular carcinoma[J]. Liver Cancer, 2016, 5: 235-244.
[29] Xue J, Ni H, Wang F, et al. Advances in locoregional therapy for hepatocellular carcinoma combined with immunotherapy and targeted therapy[J]. J Intervent Med, 2021, 4: 105-113.
[30] Liu X, Qin S. Immune checkpoint inhibitors in hepatocellular carcinoma: opportunities and challenges[J]. Oncologist, 2019, 24: S3-S10.
[31] Llovet JM, Montal R, Sia D, et al. Molecular therapies and precision medicine for hepatocellular carcinoma[J]. Nat Rev Clin Oncol, 2018, 15: 599-616.

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备注/Memo

备注/Memo:
(收稿日期:2021-12-23)
(本文编辑:新 宇)
更新日期/Last Update: 2023-01-11