[1]张学贤,万 程,赵 卫,等.DEB- TACE联合阿帕替尼治疗肝癌伴门脉癌栓的有效性及安全性[J].介入放射学杂志,2021,30(03):282-287.
 ZHANG Xuexian,WAN Cheng,ZHAO Wei,et al.Efficacy and safety of DEB-TACE combined with apatinib in the treatment of hepatocellular carcinoma with portal vein tumor thrombus[J].journal interventional radiology,2021,30(03):282-287.
点击复制

DEB- TACE联合阿帕替尼治疗肝癌伴门脉癌栓的有效性及安全性()

PDF下载中关闭

分享到:

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

卷:
30
期数:
2021年03
页码:
282-287
栏目:
临床研究
出版日期:
2021-03-29

文章信息/Info

Title:
Efficacy and safety of DEB-TACE combined with apatinib in the treatment of hepatocellular carcinoma with portal vein tumor thrombus
作者:
张学贤 万 程 赵 卫 杨 凯 冯超凡 熊 峰
Author(s):
ZHANG Xuexian WAN Cheng ZHAO Wei YANG KaiFENG Chaofan XIONG Feng.
Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, China
关键词:
【关键词】 肝细胞癌 门脉癌栓 DEB- TACE 阿帕替尼。
文献标志码:
A
摘要:
【摘要】 目的 评价载药微球经肝动脉化疗栓塞术(DEB-TACE)联合阿帕替尼治疗肝细胞癌伴门脉癌栓(PVTT)的有效性及安全性。方法 选取2017年5月至2019年1月收治的70例肝癌伴PVTT患者为研究对象,根据治疗方法分成DEB- TACE联合阿帕替尼组(n=35)和DEB- TACE组(n=35),用改良实体瘤疗效评价标准(mRECIST)评价术后肿瘤客观缓解率(ORR)及疾病控制率(DCR),通过增强CT或MRI观察术后癌栓的变化情况。随访观察患者的无进展生存时间(PFS)、总生存时间(OS)和与阿帕替尼相关的不良反应。结果 联合组术后1、3和6个月ORR分别为91%、66%、51%, DCR分别为94%、91%、80%;DEB- TACE组术后1、3和6个月 ORR分别为85%、37%、26%, DCR分别为91%、66%、54%;联合组与DEB- TACA组术后1个月ORR、DCR差异无统计学意义(P>0.05),术后3、6个月ORR、DCR差异有统计学意义(P<0.05),联合组术后1个月癌栓消退率为49%,DEB- TACE组为23%,联合组显著高于DEB- TACE组,差异有统计学意义(P<0.05),联合组mPFS为9个月(95%CI:7.712~10.288),DEB- TACE组为6个月(95% CI:4.952~7.048),联合组mOS为18个月(95%CI:14.365~21.635),DEB- TACE组为13个月(95%CI:11.541~14.459),联合组与DEB- TACE组相比,mPFS、mOS差异均具有统计学意义(P<0.05)。联合组出现5例Ⅲ级不良反应,经药物剂量减量或对症处理后好转,其余均为Ⅰ、Ⅱ级不良反应。结论 DEB- TACE联合阿帕替尼治疗肝癌伴门脉癌栓患者临床疗效及安全性较好,值得推广。

参考文献/References:

[1] 何 健,陈晓明. 2018年肝癌TACE治疗研究进展[J]. 循证医学, 2019, 19:21- 22.
[2] 安天志,高 嵩,靳 勇,等. 中国肝细胞癌经动脉化疗栓塞治疗(TACE)临床实践指南[J]. 介入放射学杂志, 2018, 27:1117- 1126
[3] 赵灵华,曾 斌. 贝伐单抗联合肝动脉化疗栓塞术治疗原发性肝癌的临床疗效及安全性评价[J]. 中国临床药理学杂志, 2016, 32:126- 128.
[4] Lee JM, Jang BK, Lee YJ, et al. Survival outcomes of hepatic resection compared with transarterial chemoembolization or sorafenib for hepatocellular carcinoma with portal vein tumor thrombosis[J]. Clin Mol Hepatol, 2016, 22: 160- 167.
[5] 崔 鹏,杜小丽,周 瀚,等. TACE治疗肝癌伴门脉癌栓患者的预后分析[J]. 介入放射学杂志, 2018, 27:266- 271.
[6] 金鑫荔,卢 伟. TACE联合阿帕替尼治疗中晚期肝细胞癌[J].中国介入影像与治疗学, 2017, 14:200- 204.
[7] 崔建东,罗 敏,李 涛,等. 阿帕替尼联合肝动脉化疗栓塞治疗中晚期肝癌的疗效及安全性分析[J]. 现代肿瘤医学, 2019, 27:2553- 2556.
[8] Wei Y,Liu JJ,Yan M, et al. Effectiveness and safety of combi-nation therapy of transarterial chemoembolization and apatinib for unresectable hepatocellular carcinoma in the chinese population: a meta- analysis[J]. Chemotherapy, 2019, 64: 94- 104.
[9] 程树群,吴孟超,陈 汉,等. 肝癌门静脉癌栓分型的影像学意义[J]. 中华普通外科杂志, 2004, 19:200- 201.
[10] Ni JY, Fang ZT, An C, et al. Comparison of albumin- bilirubin grade, platelet- albumin- bilirubin grade and Child- Turcotte- Pugh class for prediction of survival in patients with Large hepatocellular carcinoma after transarterial chemoembolization combined with microwave ablation[J]. Int J Hyperthermia, 2019, 36: 841- 853.
[11] 皋文君. 刘砚燕,袁长蓉. 国际肿瘤化疗药物不良反应评价系统——通用不良反应术语标准4.0版[J]. 肿瘤, 2012, 32:142- 144.
[12] 姚雪松,李 槐. 不可手术切除的肝细胞癌的疗效评价标准——改良RECIST标准更可靠[J]. 介入放射学杂志, 2012, 21:177- 179.
[13] Kokudo T, Hasegawa K, Matsuyama Y, et al. Survival benefit of liver resection for hepatocellular carcinoma associated with portal vein invasion[J]. J Hepatol, 2016, 65: 938- 943.
[14] Edeline J, Boucher E, Rolland Y, et al. Comparison of tumor response by Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST in patients treated with sorafenib for hepatocellular carcinoma[J]. Cancer, 2012, 118: 147- 156.
[15] Lencioni R, Llovet JM. Modified RECIST(mRECIST) assessment for hepatocellular carcinoma[J]. Semin Liver Dis, 2010, 30:52- 60.
[16] Sanchez- Delgado J, Vergara M, Machlab S, et al. Analysis of survival and prognostic factors in treatment of hepatocellular carcinoma in Spanish patients with drug- eluting bead transar-terial chemoembolization[J]. Eur J Gastroenterol Hepatol, 2018, 30: 1453- 1460.
[17] Zou JH, Zhang L, Ren ZG, et al. Efficacy and safety of cTACE versus DEB- TACE in patients with hepatocellular carcinoma: a meta- analysis[J]. J Dig Dis, 2016, 17: 510- 517.
[18] Gorodetski B, Chapiro J, Schernthaner R, et al. Advanced- stage hepatocellular carcinoma with portal vein thrombosis: conventional versus drug- eluting beads transcatheter arterial chemoembo-lization[J]. Eur Radiol, 2017, 27: 526- 535.
[19] Chung GE, Lee JH, Kim HY, et al. Transarterial chemoembo-lization can be safely performed in patients with hepatocellular carcinoma invading the main portal vein and may improve the overall survival[J]. Radiology, 2011, 258: 627- 634.
[20] 林 岩. 榄香烯注射液联合甲磺酸阿帕替尼抗肝癌的实验研究[D]. 南京:南京中医药大学, 2014:1-74.
[21] Lu W, Jin XL, Yang C, et al. Comparison of efficacy between TACE combined with apatinib and TACE alone in the treatment of intermediate and advanced hepatocellular carcinoma: a single- center randomized controlled trial[J]. Cancer Biol Ther, 2017, 18: 433- 438.

相似文献/References:

[1]姚雪松,李 槐.不可手术切除的肝细胞癌的疗效评价标准——改良RECIST标准更可靠[J].介入放射学杂志,2012,(03):177.
 . Therapeutic evaluation criterion of inoperable hepatocellular carcinomas: modified RECIST as a more reliable standard[J].journal interventional radiology,2012,(03):177.
[2]钱晟,颜志平.门脉支架置放术治疗原发性肝癌伴门脉癌栓一例[J].介入放射学杂志,2000,(04):250.
[3]贾雨辰,程红岩,陈栋,等.原发性肝癌的介入治疗[J].介入放射学杂志,1997,(02):113.
[4]顾苏滨,周群慧.提高间接法门脉造影质量的DSA技术措施[J].介入放射学杂志,1996,(01):41.
[5]梁茂全,苏洪英. 肝癌化疗栓塞前后甲胎蛋白变化模式的临床意义[J].介入放射学杂志,2012,(04):333.
 .The transformation pattern of serum аfetoprotein after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma: its clinical significance [J].journal interventional radiology,2012,(03):333.
[6]卢丽琴,陈方宏,袁建华,等.晚期肝癌伴门脉癌栓的介入治疗[J].介入放射学杂志,1996,(03):136.
[7]程永德.动脉灌注化疗并栓塞治疗肝癌的若干问题[J].介入放射学杂志,1999,(04):186.
[8]程永德.动脉灌注化疗并栓塞治疗肝癌的若干问题[J].介入放射学杂志,1999,(04):186.
[9]孙 磊,施海彬,刘 圣,等.肝细胞癌肝动脉门静脉分流形成的相关因素分析[J].介入放射学杂志,2012,(03):206.
 ,,et al.The factors related to the formation of arterioportal shunting in patients with hepatocellular carcinomas [J].journal interventional radiology,2012,(03):206.
[10]沈海洋,刘瑞宝,刘 岩,等. 肝右叶前、后段原发性肝癌TACE后VEGF及CD34的表达水平 ;[J].介入放射学杂志,2012,(06):469.
 SHEN Hai- yang,LIU Rui- bao,LIU Yan,et al. The expression levels of vascular endothelial growth factor and CD34 in residual cancerous tissues of primary hepatocellular carcinoma located at anterior and posterior segments of right lobe liver after TACE[J].journal interventional radiology,2012,(03):469.

备注/Memo

备注/Memo:
(收稿日期:2019- 11- 11)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2021-03-25