酪氨酸激酶抑制剂联合肝动脉化疗栓塞治疗肝细胞癌的近远期疗效

摘要/Abstract

摘要： 目的探讨酪氨酸激酶抑制剂联合肝动脉化疗栓塞肝细胞癌的近远期疗效。方法 2019年6月至2021年6月枞阳县人民医院收治的肝细胞癌患者60例。采用随机数字表法将患者分为治疗组30例和对照组30例,治疗组接受酪氨酸激酶抑制剂联合肝动脉化疗栓塞治疗,对照组接受传统肝动脉化疗栓塞治疗。评估治疗效果、肝功能、血清AFP水平、生存期、安全性等。结果治疗后治疗组患者CR＋PR比例高于对照组为90.00%(27/30)比66.67%(20/30),差异有统计学意义(χ²=4.811,P=0.028);治疗6周后ALT为(40.92±6.09)U/L,低于对照组的(46.33±8.13)U/L;治疗9周后血清AFP水平对照组为(153.25±42.23)μg/L,高于治疗组的(74.61±18.29)μg/L;治疗组的无进展生存期为(22.41±2.88)个月,总生存期为(34.18±5.77)个月,对照组无进展生存期为(14.17±3.14)个月,总生存期为(21.68±5.36)个月,两组不良反应发生率比较差异无统计学意义(P<0.05)。结论酪氨酸激酶抑制剂联合肝动脉化疗栓塞肝细胞癌的近远期疗效均较好。

关键词: 肝细胞癌, 肝动脉化疗栓塞, 酪氨酸激酶抑制剂, 生存质量, 疗效

Abstract: Objective To explore the short-term and long-term efficacy of tyrosine kinase inhibitors (TKI) combined with hepatic artery chemoembolization (HAC) for the treatment of hepatocellular carcinoma (HCC). Methods The study focused on 60 HCC patients collected at Zongyang County People's Hospital from June 2019 to June 2021. The patients were divided into a treatment group and a control group with 30 cases in each group using a random number table method. The treatment group received TKIs combined with HAC treatment, while the control group received traditional hepatic artery chemoembolization treatment.The treatment efficacy, liver function, serum AFP levels, survival time, safety, etc, were evaluated. Results Following the treatment, the treatment group exhibited a higher proportion of CR and PR compared to the control group (90.00% vs. 66.67%, P<0.05). After 6 weeks of treatment, the ALT was 40.92 ± 6.09 (U/L), which was lower than the control group's 46.33 ± 8.13 (U/L); After 9 weeks of treatment, the serum AFP level in the control group was 153.25 ± 42.23 μg/L, which was higher than the treatment group's 74.61 ± 18.29 μg/L; The progression free survival of the treatment group was 22.41 ± 2.88 months, with a total survival of 34.18 ± 5.77 months. The progression free survival of the control group was 14.17 ± 3.14 months, the overall survival in the study group was 21.68 ± 5.36 months. There were no statistically significant difference in the incidence of adverse reactions was observed between the two groups (P>0.05). Conclusion The combination of TKIs and HAC treatment for HCC has shown good therapeutic effects in short and long term, which has clinical promotion value.

Key words: hepatocellular carcinoma, Hepatic artery chemoembolization, Tyrosine kinase inhibitors, Quality of life, curative effect

钱叶强, 高路, 余春来. 酪氨酸激酶抑制剂联合肝动脉化疗栓塞治疗肝细胞癌的近远期疗效[J]. 肝脏, 2024, 29(7): 780-783.

QIAN Ye-qiang, GAO Lu, YU Chun-lai. An analysis on the short-term and long-term therapeutic effects of tyrosine kinase inhibitors combined with hepatic artery chemoembolization for the treatment of hepatocellular carcinoma[J]. Chinese Hepatolgy, 2024, 29(7): 780-783.

/ 推荐

参考文献

[1] Ling L, Zhen HZ, Yan G, et al.The perioperative experience and needs of hepatocellular carcinoma patients in interventional therapy: a phenomenological qualitative study[J]. Eur J Gastroenterol Hepatol,2024,36(4):423-429.
[2] Cassese G,Han SH, Yoon SY, et al.Evolution of laparoscopic liver resection in the last two decades: lessons from 2000 cases at a referral Korean center.[J].Surg Endosc,2024,38(3):1200-1210.
[3] Cheo YF, Lim F HC, Chan SK, et al.The impact of waiting time and delayed treatment on the outcomes of patients with hepatocellular carcinoma: a systematic review and meta-analysis.[J].Ann Hepatobiliary Pancreat Surg,2024,28(1):11-13.
[4] 赵雨婷,王洪智,董德左,等. 放疗联合动脉化疗栓塞及酪氨酸激酶抑制剂治疗肝癌合并瘤栓的长期结果[J]. 中华放射医学与防护杂志,2022,42(8):577-583.
[5] 朱斌,周彬. 肝动脉化疗栓塞联合B超引导下微波消融治疗原发性肝癌患者的临床研究[J]. 中国临床药理学杂志,2023,39(8):1077-1081.
[6] 杨秉辉,夏景林.原发性肝癌的临床诊断与分期标准.中华肝脏病杂志,2001,7(6):59-60.
[7] 周际昌,主编.实用肿瘤内科学.第2版.北京:人民卫生出版社,2003,45-46.
[8] 郭梦雅,邵晓雯,黄佳宁,等. LINC02870对肝细胞性肝癌细胞增殖的影响及机制[J]. 山东医药,2022,62(31):48-51.
[9] Chu JK, Kawaguchi Y, Wang H, et al.Update on the diagnosis and treatment of combined hepatocellular cholangiocarcinoma.[J].J Clin Transl Hepatol,2024,12(2):210-217.
[10] 赵桓玉,张瑞瑞,张正卫,等. 肝细胞癌中磷脂酰肌醇蛋白聚糖-3的表达及其临床意义[J]. 肝脏,2022,27(11):1180-1182.
[11] Kudo M, Ueshima K, Saeki I, et al.A phase 2, prospective, multicenter, single-arm trial of transarterial chemoembolization therapy in combination strategy with lenvatinib in patients with unresectable intermediate-stage hepatocellular carcinoma: TACTICS-L Trial.[J].Liver cancer,2024,13(1):199-112.
[12] Cao ZY, Zheng LG, Zhang QT, et al.Hepatic arterial infusion chemotherapy with anti-angiogenesis agents and immune checkpoint inhibitors for unresectable hepatocellular carcinoma and meta-analysis.[J].World journal of gastroenterology,2024,30(4):318-331.
[13] 刘慧慧,魏静瑶,张丽珍,等. 酪氨酸激酶抑制剂引起的肝损伤机制研究进展[J]. 中国药理学通报,2023,39(9):1613-1617.
[14] 王研,王小玲,吕国庆,等. 慢性髓细胞性白血病酪氨酸激酶抑制剂优化治疗的研究进展[J]. 山东医药,2023,63(13):112-115.
[15] 宋震,李园园,王文刚,等. TACE联合酪氨酸激酶抑制剂和卡瑞利珠单抗对中晚期肝癌的疗效与安全性[J]. 介入放射学杂志,2023,32(6):549-553.
[16] 李榕,李文利,袁国盛,等. 肝动脉灌注化疗术联合靶免对比经动脉插管化疗栓塞术联合靶免治疗中晚期肝癌患者术后引起肝损伤的研究[J]. 中华肝脏病杂志,2023,31(11):1163-1168.
[17] Li Y, Sui S, Goel A .Extracellular vesicles associated microRNAs: their biology and clinical significance as biomarkers in gastrointestinal cancers[J].Seminars in Cancer Biology,2024,995-923.
[18] 徐明洲,范小斌,何明,等. 老年肝癌患者介入术后医院感染危险因素及 MFG-E8、MMP-13、AFP 诊断价值[J]. 中华医院感染学杂志,2023,33(18):2795-2799.
[19] 刘畅,余安琪,池奋清,等. 酪氨酸激酶抑制剂BGJ398对人肝癌Huh-7细胞增殖、凋亡及迁移的影响及其作用机制[J]. 中国生物制品学杂志,2023,36(8):947-954.
[20] Federico G, Monica F, Serena G, et al.La PET/TC nell'era degli agenti citostatici: ruolo nella valutazione della risposta alla terapia con inibitori della tirosin-chinasi (TKI) nel carcinoma tiroideo[J].L'Endocrinologo,2024,25(1):54-60.
[21] 伦永志,孙杰,魏玲,等. 基于整合转录组学分析丝氨酸蛋白酶抑制剂Hespintor抑制肝癌裸鼠移植瘤生长的潜在机制[J]. 西安交通大学学报(医学版),2022,43(2):202-212.