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目的研究不同方案对肝癌肝移植术后肺部转移瘤的治疗效果。方法肝癌肝移植术后肺部转移瘤患者19例,A组14例索拉非尼联合消癌平口服液治疗,B组5例放射治疗。结果 A组随访5~33个月,2例患者分别于治疗第5、7个月死亡,1例患者治疗6个月转移瘤消失,2例患者治疗第3、4个月转移瘤逐步减小,9例患者良好带瘤生存;索拉非尼半量治疗者,2例生存超过20月,5例超过12个月;B组患者6个月内死亡3例,余2例肿瘤进展明显。两组间总体生存率分别为85.7%、40.0%,有显著统计学差异(P=0.022)。结论肝癌肝移植术后复发者肺部转移瘤常见。索拉非尼联合消癌平口服液治疗肝移植术后肺部转移瘤疗效确切,显著延长生存时间,半量治疗者联合消癌平口服液也能取得良好的疗效;放射治疗肝移植术后肺部转移瘤效果不佳。
Objective To study the effect of different regimens on lung metastases after liver transplantation. Methods 19 patients with pulmonary metastases after hepatocellular carcinoma liver transplantation were treated. In group A, 14 patients were treated with sorafenib and Xiaoaiping oral solution, and 5 patients in group B were treated with radiation. Results A group was followed up for 5 to 33 months. Two patients died at the 5th and 7th months of treatment. One patient lost 6 months of metastasis and 2 patients showed gradual reduction of metastases at 3 and 4 months of treatment. Nine patients had good tumor survival; in patients treated with sorafenib half-dosage, 2 patients survived more than 20 months and 5 patients more than 12 months; group B patients died within 6 months and 3 patients showed significant tumor progression. The overall survival rate between the two groups was 85.7% and 40.0%, respectively, with statistical significance (P=0.022). Conclusions Liver metastases are common in patients with recurrence after liver transplantation. Sorafenib combined with Xiaoaiping Oral Liquid has a definite curative effect on metastatic lung metastases after liver transplantation. It significantly prolongs survival time, and half-dosagers combined with Xiaoaiping Oral Liquid can also achieve good efficacy; Radiotherapy for liver after liver transplantation Department of metastases is not effective.