摘要
目的 探讨XELOX方案治疗索拉菲尼耐药晚期原发性肝癌的临床疗效及对预后生存的影响。方法 选取2012年1月至2013年1月收治的经单纯索拉菲尼治疗耐药的原发性肝癌患者64例,均采用XELOX方案治疗,其中肝细胞癌50例为A组,胆管细胞癌10例为B组,肝细胞癌/胆管细胞癌混合型4例为C组。采用系统性回顾法分析患者的临床和随访资料,统计所有患者在予以XELOX方案治疗过程中血清甲胎蛋白（AFP）水平及合并慢性乙肝患者其HBV DNA水平的变化,并评价XELOX方案治疗后患者的临床疗效、不良反应及预后生存情况。结果 64例患者中,疾病总控制率为84.38%（54/64）,且在乙型肝炎患者中4例患者HBV DNA被再次激活,予相关抗病毒治疗后恢复正常,甲胎蛋白下降28例（43.75%）。不良反应最严重的为Ⅰ～Ⅱ级手足皮肤反应,共12例（18.75%）,除肝功能损害给予相关药物治疗好转外,其他不良反应在停药数天后均自行消失,且均可耐受不良反应。所有患者的生活质量均良好,其中肝细胞癌患者预后最好,其他2种类型尚可,差异无统计学意义（P〉0.05）;中位无进展生存期为5.84个月,中位总生存期为11.94个月。结论 XELOX方案治疗对索拉菲尼耐药的晚期原发性肝癌临床疗效良好,预后生存率及生活质量均较好,可作为临床治疗原发性肝癌的一线治疗方案。
Objective To investigate the clinic efficacy and prognosis analysis of Xelox on sorafenib drug treating fast advanced primary hepatic cancer. Methods 64 cases failed by simple sorafenib in the hospital from January 2012 to January 2013 were selected. All pa- tients were treated with Xelox regimen. Among them, 50 cases of hepatocellular carcinoma were group A, 10 cases of cholangiocarcinoma were group B, and 4 cases of hepatocellular carcinoma/cholangiocarcinoma were group C. Retrospective analysis was conducted on the clinical and follow- up patient data. The AFP level and HBV DNA changes of patients after treatment of Xelox were recorded, the clin- ic efficacy, adverse reactions and prognosis of the patients were evaluated. Results After treatment, the total control rate of all patients was 84.38% （54/64）; 4 cases with hepatitis B, the HBV DNA of were reactivate and returned to normal after antivirus treatment; 28 cases （43.75%） had AFP declination. During treatment, the most severe adverse reaction was Ⅰ- Ⅱ level hand-foot skin reaction （12 cases, 18.75% ）; besides the liver function lesion improvement after relevant medication, other adverse reactions disappeared a few days gter the stop of medication, and were all tolerable adverse reactions. The prognosis of the patients with hepatocellular carcinoma im- proved best, other 2 types were fair, and the difference was not statistic significant（ P 〉 0. 05）. The total meso- position PFS was 5.84 months, OS meso- position was 11.94 months. Conclusion Xelox achieves better clinic effect on sorafenib drug treating fast advanced primary hepatic cancer, and the survival rate, life quality are better, which can be seen as a first therapeutic schedule for primary liver cancer.
出处
《中国药业》
CAS
2016年第21期52-54,共3页
China Pharmaceuticals
