摘要
目的 探讨微波消融联合索拉非尼及经导管动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗老年晚期原发性肝癌患者的疗效及预后影响因素。方法 回顾性分析2019年4月至2020年4月邯郸市传染病医院收治的145例老年晚期原发性肝癌患者的临床资料。根据治疗方式不同分为未联合微波消融组(66例)和联合微波消融组(79例)。未联合微波消融组给予索拉非尼联合TACE治疗,联合微波消融组给予微波消融联合索拉非尼及TACE治疗。比较两组治疗3个月后的疗效、不良反应及1年生存率,并通过多因素COX比例风险模型进行预后影响因素分析。结果 治疗3个月后,联合微波消融组疾病控制率为73.4%(58/79),明显高于未联合微波消融组(57.6%,38/66),差异有统计学意义(P<0.05),但治疗期间两组不良反应发生情况比较,差异无统计学意义(P>0.05)。联合微波消融组的1年生存率为62.0%(49/79),明显高于未联合微波消融组的36.4%(24/66),差异有统计学意义(P=0.000)。COX回归分析显示,肿瘤直径≥6 cm(HR=2.814,95%CI:1.747~4.532,P<0.001)是影响老年晚期原发性肝癌预后的独立危险因素,而接受微波消融治疗为保护因素(HR=0.322,95%CI:0.205~0.538,P<0.001)。结论 微波消融联合索拉非尼及TACE是治疗老年晚期原发性肝癌的有效手段。
Objective To investigate the effect and influence factors of microwave ablation combined with sorafenib and transcatheter arterial chemoembolization(TACE) in elderly patients with advanced primary hepatic carcinoma(PHC).Methods The clinical data of 145 elderly patients with advanced PHC treated in Handan Infectious Disease Hospital from April 2019 to April 2020 were retrospectively analyzed. The patients were divided into two groups according to different treatment methods. There were 66 patients in the uncombined microwave ablation group and 79 patients in the combined microwave ablation group. The uncombined microwave ablation group was given sorafenib combined with TACE therapy,and the combined microwave ablation group was given microwave ablation combined with sorafenib and TACE therapy. The three-month short-term efficacy, adverse reactions, and one-year survival rate of the two groups were compared, and the prognostic factors were analyzed using the COX proportional hazard model. Results After three-months of treatment, the disease control rate of the combined microwave ablation group was 73.4%(58/79), which was significantly higher than that of the uncombined microwave ablation group(57.6%, 38/66), the difference was statistically significant(P<0.05).However, there were no significant differences in the incidence of adverse reactions between the two groups during the treatment period(P>0.05). The one-year survival rate of the combined microwave ablation group was 62.0%(49/79), which was significantly higher than that of the uncombined microwave ablation group was 36.4%(24/66), the difference was statistically significant(P = 0.000). COX regression analysis showed that tumor diameter ≥ 6 cm(HR = 2.814, 95 %CI: 1.747-4.532, P<0.001) was an independent risk factor and microwave ablation was a protective factor(HR = 0.322, 95 %CI: 0.205-0.538, P<0.001) of the prognosis of advanced PHC. Conclusions Microwave ablation combined with sorafenib and TACE is an effective treatment for elderly patients with advanced
作者
刘改玲
张沙沙
周红霞
Liu Gailing;Zhang Shasha;Zhou Hongxia(Department of Severe Liver Diseases,Handan Infectious Disease Hospital,Handan 056002,China)
出处
《北京医学》
CAS
2022年第2期124-127,131,共5页
Beijing Medical Journal
关键词
原发性肝癌
经导管动脉化疗栓塞术
微波消融
索拉非尼
老年
primary hepatic carcinoma(PHC)
transcatheter arterial chemoembolization(TACE)
microwave ablation
sorafenib
elderly
