【摘要】 目的回顾性分析索拉非尼(sorafenib)治疗晚期原发性肝癌的疗效,分析影响预后的危险因素,对索拉非尼治疗中国患者的疗效和安全性做出评估。方法回顾性分析应用索拉非尼治疗的52例晚期肝癌患者的临床资料,采用Kaplan-Meier法和Cox回归分析影响生存期的危险因素,并统计不良反应发生情况。结果索拉非尼治疗的52例患者中位总体生存期是14.2(9.5～18.9)个月。22例(42.3%)出现疾病进展(PD),2例(3.8%)出现部分缓解(PR),28例(53.8%)疾病稳定(SD),疾病控制率达到57.7%。Cox回归分析显示,肝功能Child-PughA级(HR=0.3,P=0.049),疾病进展时间大于2个月(HR=4.1,P=0.049)和接受其他形式的联合治疗(HR=0.4,P=0.026)是延长中位生存期的独立预后因素。最常见的3级毒性反应是手足综合征(17.3%)和腹泻(7.7%)。结论索拉非尼治疗晚期晚期患者有较好的疗效和耐受性,是否联合其他治疗和治疗过程的反应可能影响远期预后。更多还原

【Abstract】 Objective To investigate the efficacy and safety in sorafenib-treated HCC patients and to identify the prognostic factors.Methods In this retrospective study,52 patients were given 400 mg of sorafenib b.d.Baseline clinical parameters,adverse events(AEs) and survival data were collected.Kaplan-Meier and Cox regress analysis were performed to reveal the prognostic factors for survival.Results The median OS for all sorafenib-treated patients was 14.2(9.5-18.9) months.Of all the patients,2(3.8%) had a partial response(PR),22 had a progressive disease(PD) and the remaining 28 had shown a stable disease(SD).The disease-control rate was 57.7%.The multivariate analysis revealed that patients of Child-Pugh class A(HR = 0.3,P = 0.049),PD less than 2 months(HR = 4.1,P = 0.049),and receiving other combined treatment modalities(HR = 0.4,P = 0.026) were independent prognostic factors for longer OS.The most common grade 3 toxicities were hand-foot syndrome(17.3%) and diarrhea(7.7%).Conclusions Sorafenib demonstrates a good outcome and tolerable toxicity in Chinese advanced HCC patients.The treatment modality and patients’ response to sorafenib therapy are associated with survival prognosis.更多还原