摘要
目的 对几种治疗中晚期肝癌（HCC）的方法进行比较,以期指导今后临床工作.方法 回顾我院近7年126例中晚期肝癌患者随访资料.患者按治疗方法分为六组：未治疗组、TACE组、手术组、TACE＋索拉非尼组、手术＋TACE组、手术＋TACE＋索拉非尼组.应用Kaplan-Meier生存曲线进行生存分析,应用log-rank检验各组结果.结果 对非手术患者,TACE＋索拉非尼治疗组1年生存率和中位生存期分别为62.5％和16个月,优于未治疗组和单纯TACE组.手术治疗组1年及总生存期明显优于非手术各组.单纯手术组、手术＋TACE组、手术＋TACE＋索拉非尼组1年和2年生存率分别为87％、95％、88.9％和52.2％、50.0％、55.6％,三组间比较差异无统计学意义;但3年生存率手术＋ TACE＋索拉非尼组明显高于单纯手术组和手术＋TACE组.三组的中位生存期分别为24、24.5和28个月.三组术后复发后中位生存期分别为7、9.5、和18个月,索拉非尼治疗可显著延长术后复发患者的总体生存时间.结论 中晚期HCC治疗效果仍以手术最好,应首选.对于不能手术切除的HCC患者,TACE联和索拉非尼治疗是较好的选择.索拉非尼能有效控制HCC术后复发的进展,显著延长患者带瘤生存时间,可能是预防和治疗HCC术后复发的最佳措施.
Objective To analyze the outcomes of different treatments in 126 patients with advanced hepatocellular carcinoma （HCC）.Methods The follow-up data of 126 BCLC-B or C stage HCC patients who received different treatments were retrospectively studied.These patients were divided into six groups according to the treatment.Group 1：untreated; Group 2：TACE only; Group 3：TACE ＋ Sorafenib;Group 4：liver resection ; Group 5：liver resection ＋ TACE; Group 6：liver resection ＋ TACE ＋ Sorafenib.The survival times were analyzed using Kaplan-Meier method and the results were analyzed using the log-rank test.Results Among the non-surgery groups,the 1 year survival rate in Group 3 （62.5％,medium survival 16 months） was longer than Groups 1 and 2.For patients in the liver resection groups,the 1 year and overall survival rates were much better than the non-surgery groups.There were no significant differences in 1 year and 2 year survivals among Groups 4,5,and 6.However,the 3 year survival rate in Group 6 was much longer than Groups 4 and 5.The medium survival in Groups 4,5,and 6 were 24,24.5,and 28 months,respectively.Moreover,the medium survivals after post-hepatectomy recurrence in Groups 4,5 and 6 were 7,9.5,and 18 months,respectively.Sorafenib significantly prolonged survival after HCC recurrence.Conclusions Liver resection was still the best and the most effective treatment for patients with advanced HCC.Combining TACE with Sorafenib was a better treatment for patients with non-resectable HCC.Sorafenib effectively inhibited progression of post-hepatectomy HCC recurrence and significantly prolonged survival.Therefore,Sorafenib is a good approach in the prevention and treatment of HCC recurrence.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2014年第11期781-785,共5页
Chinese Journal of Hepatobiliary Surgery
基金
国家自然科学基金（81170416
8127324）
教育部博士点专项科研基金（20100061110069）
吉林省科技厅自然科学基金（201015178）和国际合作基金（2011742）
关键词
肝细胞肝癌
经肝动脉化疗栓塞
肝切除术
索拉非尼
术后复发
Hepatocellular carcinoma
Transarterial chemoembolization
Liver resection
Sorafenib
Recurrence
