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目的探讨TACE联合索拉非尼治疗肝细胞癌的疗效及安全性。方法将50例中晚期肝细胞癌患者随机分为两组,每组25例,治疗组于TACE术后5d口服索拉菲尼联合治疗,对照组单纯行TACE术。在治疗4～6周进行临床疗效评价,治疗3个月后进行生话质量评价,TACE术前1周及术后2周进行血清VEGF水平检测,并全程监测毒副反应。结果治疗组有效率为52%,疾病控制率84%,生活质量改善率80%,与对照组相比均显著提高,差异有统计学意义(P<0.05);治疗后治疗组VEGF水平显著降低,而对照组显著升高,差异均有统计学意义(P<0.05);治疗组腹泻、手足综合征、高血压、皮疹等症状较对照组高,差异有统计学意义(P<0.05)。结论索拉非尼可降低TACE术后血清VEGF水平;TACE联合索拉非尼治疗晚期肝细胞癌安全有效。
Objective To investigate the efficacy and safety of TACE and sorafenib in the treatment of hepatocellular carcinoma. Methods Fifty patients with advanced hepatocellular carcinoma were randomly divided into two groups (n = 25 in each group). The treatment group was treated with sorafenib 5 days after TACE and the control group received TACE alone. The curative effect was evaluated 4 to 6 weeks after treatment. The quality of speech was evaluated 3 months after the treatment. The level of serum VEGF was detected 1 week before TACE and 2 weeks after TACE, and the side effects were monitored. Results The effective rate of the treatment group was 52%, the disease control rate was 84% and the quality of life improvement rate was 80%, which was significantly higher than that of the control group (P <0.05). The VEGF level of the treatment group was significantly lower (P <0.05). The symptoms of diarrhea, hand-foot syndrome, hypertension and rash in the treatment group were significantly higher than those in the control group (P <0.05). Conclusion Sorafenib can reduce serum VEGF level after TACE. TACE combined with sorafenib is safe and effective in the treatment of advanced hepatocellular carcinoma.