目的评价经肝动脉化疗栓塞(TACE)联合恩度和索拉非尼治疗肝细胞肝癌(HCC)的疗效。方法 60例HCC患者均分为两组:C组单纯行TACE治疗;A组TACE联合恩度(动脉灌注30mg+静脉滴注15mg/d)和索拉非尼(口服800mg/d)治疗。ELISA法检测治疗前后血清低氧诱导因子1α(HIF-1α)、血管内皮生长因子(VEGF)水平。2个疗程结束后评价疗效及不良反应。结果 A组治疗后血清HIF-1α和VEGF水平均低于术前[(156.3±22.9)pg/ml vs.(258.8±32.7)pg/ml和(321.4±62.8)pg/ml vs.(426.6±56.7)pg/ml](P〈0.05)。A组有效率高于C组(86.7%vs.40.0%)(P〈0.01)。两组不良反应经对症处理后均获缓解。结论 TACE联合恩度和索拉非尼治疗HCC的近期疗效好,不良反应可耐受。
Objective To evaluate the efficacy of transcatheter arterial chemoembolization(TACE)combined with endostar and sorafenib in the treatment of hepatocellular carcinoma(HCC).Methods Sixty HCC patients were divided into two groups of A(treated with TACE+arterial infusion of endostar 30mg+intravenous infusion of endostar 15mg/d+oral sorafenib 800mg/d)and C(treated with TACE alone).Serum levels of hypoxia inducible factor 1α(HIF-1α)and vascular endothelial growth factor(VEGF)were detected by ELISA before and after treatment.Clinical efficacy and adverse effects in both groups were evaluated as well.Results Serum levels of HIF-1αand VEGF after treatment were lower than those before in group A[(156.3±22.9)pg/ml vs.(258.8±32.7)pg/ml and(321.4±62.8)pg/ml vs.(426.6±56.7)pg/ml](P〈0.05)。The effectiveness rate in group A was higher than that in group C(86.7% vs.40.0%)(P〈0.01)。Adverse effects in two groups were alleviated after symptomatic treatment.Conclusion A better short-term efficacy can be obtained by treating HCC patients with TACE in the combination of endostar and sorafenib.The adverse effects are tolerable.