TACE联合安替可治疗原发性肝癌的疗效

doi:10.3760/cma.j.issn.1673-422X.2019.04.007

摘要/Abstract

摘要： 目的评价经导管动脉化疗栓塞(TACE)联合安替可治疗原发性肝癌的疗效。方法回顾性分析河北北方学院附属第一医院2016年8月至2017年12月收治的72例原发性肝癌患者（共90个病灶）资料，根据治疗方案分为观察组（n=36）和对照组（n=36），对照组（40个病灶）仅给予TACE治疗，观察组（50个病灶）在TCAE治疗同时口服安替可，2粒/次，每日3次，拟定6周为1个治疗周期，共完成4个周期的治疗，所有患者分别于TACE治疗前1周和治疗6个月后各进行1次CT增强扫描，依据实体瘤疗效评价标准，以完全缓解及部分缓解为总有效，分析两组患者肿瘤大小变化、术后肿瘤残存、肿瘤包膜生长情况、新发肝内转移瘤等影像资料，评价两组患者的治疗效果。结果治疗6个月后观察组总有效病灶39个，对照组23个，观察组总有效率高于对照组（78.0%∶57.5%），差异有统计学意义(χ2=4.357，P=0.037)；观察组检出新生肿瘤包膜病灶23个，对照组检出9个，观察组新生肿瘤包膜检出率高于对照组（46.0%∶22.5%），差异有统计学意义(χ2=5.356，P=0.021)；观察组发现肿瘤残存病灶27个、新发肝内转移瘤5例，对照组肿瘤残存病灶30个、新发肝内转移瘤13例，观察组肿瘤残存率、新生肝内转移率均低于对照组（54.0%∶75.0%；13.9%∶36.1%），差异均有统计学意义（χ2=4.220，P=0.040；χ2=4.741，P=0.029)。结论 TACE联合安替可治疗原发性肝癌安全有效，能够提高临床总有效率，促进肿瘤包膜生长，降低肿瘤复发率和转移率，值得临床推广应用。

关键词: 体层摄影术, 螺旋计算机, 肝肿瘤, 经导管动脉化疗栓塞, 安替可

Abstract: Objective To evaluate the curative effect of transcatheter arterial chemoembolization (TACE) combined with Antike in the treatment of primary liver cancer. Methods The data of 72 patients with primary liver cancer (90 lesions in total) admitted to the First Affiliated Hospital of Hebei North University from August 2016 to December 2017 were retrospectively analyzed. All patients were divided into the observation group (n=36) and the control group (n=36) according to the therapeutic schedule. The patients in the control group (40 foci) were treated with TACE only, and the patients in the observation group (50 foci) received TCAE treatment, oral Antike capsules were taken at the same time with the frequency of three times a day, two capsules each time, and six weeks were planned for one treatment cycle. A total of four cycles were completed. All patients underwent CT enhancement scans one week before TACE treatment and six months after treatment. According to Response Evaluation Criteria in Solid Tumors, complete remission and partial remission were deemed as effectivity.The imaging data of the change of tumor size, postoperative tumor residual, tumor capsule growth and new intrahepatic metastases were analyzed and used to evaluate the curative effect of patients in the two groups. Results After 6 months of treatment, there were 39 effective lesions in the observation group and 23 in the control group. The total effective rate of the observation group was higher than that of the control group (78.0% vs. 57.5%), and the difference was statistically significant (χ2=4.357, P=0.037). Twenty-three neoplastic capsule lesions were detected in the observation group and 9 in the control group. The detection rate of neoplastic capsule was higher in the observation group than that in the control group (46.0% vs. 22.5%), and the difference was statistically significant (χ2=5.356, P=0.021). There were 27 residual tumors and 5 new intrahepatic metastases in the observation group, 30 residual tumors and 13 new intrahepatic metastases in the control group. The residual tumor rate and neohepatic metastasis rate in the observation group were lower than those in the control group (54.0% vs. 75.0%; 13.9% vs. 36.1%), and the differences were statistically significant (χ2=4.220, P=0.040; χ2=4.741, P=0.029). Conclusion TACE combined with Antike is safe and effective in the treatment of primary liver cancer. It can improve the total clinical efficiency, promote the growth of tumor capsule, and reduce the recurrence rate and metastasis rate of tumor. It is worthy of clinical application.

Key words: Tomography, spiral computed, Liver neoplasms, Transcatheter arterial chemoembolization, Antike

刘晓城1,李传贵1,李卫天2. TACE联合安替可治疗原发性肝癌的疗效[J]. 国际肿瘤学杂志, 2019, 46(4): 226-230.

Liu Xiaocheng1, Li Chuangui1, Li Weitian2. Curative effect of TACE combined with Antike in the treatment of primary liver cancer[J]. Journal of International Oncology, 2019, 46(4): 226-230.

参考文献

［1］ Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012［J］. CA Cancer J Clin, 2015, 65(2): 87-108. DOI: 10.3322/caac.21262. ［2］ Andrisani OM, Studach L, Merle P. Gene signatures in hepatocellular carcinoma (HCC)［J］. Semin Cancer Biol, 2011, 21(1): 4-9. DOI: 10.1016/j.semcancer.2010.09.002. ［3］邱艳艳, 曹勤, 殷佩浩. 蟾毒灵抗肿瘤作用分子机制［J］. 国际肿瘤学杂志, 2013, 40(5): 339-342. DOI: 10.3760/cma.j.issn.1673-422X.2013.05.006. ［4］ Cormier JN, Thomas KT, Chari RS, et al. Management of hepatocellular carcinoma［J］. J Gastrointest Surg, 2006, 10(5): 761-780. DOI: 10.1016/j.gassur.2005.10.006. ［5］ Ichikawa T, Machida N, Sasaki H, et al. Early prediction of the outcome using tumor markers and mRECIST in unresectable hepatocellular carcinoma patients who underwent transarterial chemoembolization［J］. Oncology, 2016, 91(6): 317-330. DOI: 10.1159/000448999. ［6］胡智明, 赵大建, 邹寿椿, 等. 难根治切除原发性肝癌经肝动脉插管化疗栓塞后二期手术切除的体会［J］. 中华肝胆外科杂志, 2012, 18(5): 361-364. DOI: 10.3760/cma.j.issn.1007-8118.2012.05.013. ［7］ Herber SC, Otto G, Woerns M, et al. Single center experience over a 5-year period with sequential transarterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC)［J］. Rofo, 2007, 179(3): 289-299. DOI: 10.1055/s-2006-927355. ［8］ Shinoda M, Kishida N, Itano O, et al. Long-term complete response of advanced hepatocellular carcinoma treated with multidisciplinary therapy including reduced dose of sorafenib: case report and review of the literature［J］. World J Surg Oncol, 2015, 13: 144. DOI: 10.1186/s12957-015-0559-9. ［9］ Ferenci P, Fried M, Labrecque D, et al. World Gastroenterology Organisation Guideline. Hepatocellular carcinoma (HCC): a global perspective［J］. J Gastrointestin Liver Dis, 2010, 19(3): 311-317. ［10］ Kudo M. Hepatocellular carcinoma 2009 and beyond: from the surveillance to molecular targeted therapy［J］. Oncology, 2008, 75(Suppl 1): 1-12. DOI: 10.1159/000181865. ［11］ Kawaguchi Y, Honda G, Endo I, et al. Current technical issues for surgery of primary liver cancer［J］. Liver Cancer, 2016, 6(1): 51-58. DOI: 10.1159/000449345. ［12］ Lee JH, Chung YH, Kim JA, et al. Genetic predisposition of handfoot skin reaction after sorafenib therapy in patients with hepatocellular carcinoma［J］. Cancer, 2013, 119(1): 136-142. DOI: 10.1002/cncr.27705. ［13］娄彦妮, 贾立群. 安替可胶囊治疗消化系统肿瘤的文献分析［J］. 中国医院用药评价与分析, 2013, 13(9): 807-809. ［14］洪卫, 朱利明, 刘碧霞, 等. 安替可胶囊联合化疗治疗晚期胃癌的临床研究［J］. 新中医, 2014, 46(6): 171-173．［15］马薇, 舒庆, 周丹, 等. 安替可胶囊对Lewis肺癌小鼠肿瘤抑制作用及其抗血管生成作用的实验研究［J］. 陕西医学杂志, 2018, 47(2): 147-149. DOI: 10.3969/j.issn.1000-7377.2018.02.003. ［16］江晓燕, 管志峰. 安替可胶囊合并放射治疗食管癌近期疗效分析［J］. 齐齐哈尔医学院学报, 2012, 33(17): 2337-2338. DOI: 10.3969/j.issn.1002-1256.2012.17.029. ［17］林兰娟, 曾勇梅, 李水云. 黄芪扶正汤对卵巢癌术后化疗患者免疫功能的影响［J］. 陕西中医, 2017, 38(2): 217-219. DOI: 10.3969/j.issn.1000-7369.2017.02.036. ［18］韩非, 陈玉华. 蒙药当归对免疫系统的药理作用研究进展［J］. 中国民族医药杂志, 2010, 16(5): 59-60. DOI: 10.3969/j.issn.1006-6810.2010.05.032. ［19］李瑛, 曹蔚, 王四旺, 等. 安替可胶囊物效基础研究进展［J］. 亚太传统医药, 2012, 8(2): 177-179. DOI: 10.3969/j.issn.1673-2197.2012.02.100. ［20］ 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(1): 160-167. DOI: 10.3350/cmh.2016.22.1.160. ［21］ Wang CH, Wey KC, Mo LR, et al. Current trends and recent advances in diagnosis, therapy, and prevention of hepatocellular carcinoma［J］. Asian Pac J Cancer Prev, 2015, 16(9): 3595-3604. ［22］董景辉, 马威, 安维民, 等. 氩氦刀联合经肝动脉化疗栓塞术治疗肝癌疗效的MRI评价［J］. 中华临床医师杂志（电子版）, 2012, 6(14): 3884-3886. DOI: 10.3877/cma.j.issn.1674-0785.2012.14.017.

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