【摘要】 目的:评价索拉非尼治疗中晚期肝细胞肝癌(HCC)的疗效和不良反应。方法:分析山东大学附属省立医院2010年1月—2014年12月应用索拉非尼治疗(每次400 mg,2次/d,必要时,治疗过程中根据不良反应调整剂量)的59例中晚期HCC患者,评价其疗效和不良反应。结果:59例患者无完全缓解病例,部分缓解8例,19例持续6个月以上病情稳定(SD),疾病控制率(DCR)为45.8%。59例患者的中位生存期(OS)为9.9个月。肝功能Child-Pugh A级患者的中位OS优于Child-Pugh B级患者(15.3个月vs 3.7个月,P=0.016);巴塞罗那分期(BCLC)B级患者的中位OS优于C级患者(19.5个月vs6.3个月,P=0.008)。59例患者的主要不良反应为手足皮肤反应、腹泻、高血压、厌食和口腔黏膜炎。总体不良反应发生率为78.2%,3级不良反应4例,2例需要短期停药,2例经减量后好转。结论:索拉非尼可以延长中晚期HCC患者的生存期;肿瘤的分期越早,患者的肝功能及体力状况越好,患者越能从中受益,其不良反应多数患者可以耐受。更多还原

【Abstract】 Objective: To investigate the efficacy and safety of sorafenib in treatment of advanced hepatocellular carcinoma(HCC). Methods: 59 advanced patients with HCC who were treated with sorafenib from January 2010 to December 2014 in Shandong Provincial Hospital Affiliated to Shandong University were reviewed. All patients took oral sorafenib at a dose of 400 mg twice daily, during the course of treatment, dose was adjusted based on the degree of the adverse effects.Tumor response to sorafenib andsafety was assessed according to the modified RECIST criteria. The survial curve for the median overall survival(m OS)were estimated. Results: In this series,there was no patients achieved complete response(CR), 8 patients achieved partial response(PR),19 patients achieved stable disease(SD)lasting for more than 6 months. The disease control rate(DCR)was 45.8%. The patients m OS was 9.9 months. Subgroup analysis according to Child-Pugh grades the m OS of patients with stage A was 15.3 months,and the patients with stage B was 3.7 months.The m OS of patients with the BCLC stage B was longer than that of the patients with Child-Pugh grades C(19.5 months versus 6.3 months). The most common adverse events were hand-foot skin reaction, diarrhea, hypertension, anorexia, and mucositis. The overall incidence of adverse events was 78.2%.Four patients had grade 3 adverse events, 2 patients required impermanency stopped taking medication while 2 patients required impermanency dose reduction. Conclusion: Sorafenib can extend the m OS in patients with advanced hepatocellular carcinoma.Patients with earlier stage of HCC and better performance status are hopeful for more positive response to the treatment of sorafenib.The side effects of sorafenib were tolerable.更多还原