Objective To investigate the therapeutic effect and adverse effects of transcatheter arterial chemoembolization( TACE) combined with thalidomide or sorafenib in the treatment of unresectable primary liver cancer. Methods A total of 102 patients who underwent TACE combined with thalidomide or sorafenib in 215 Hospital of Nuclear Industry of Shaanxi Province from January 2012 to August 2013 were enrolled and divided into TACE- thalidomide group( 49 patients) and TACE- sorafenib group( 53 patients). The short- term outcome,long- term outcome,changes in related indices,and adverse events were evaluated. The independent- samples t- test was applied for comparison of continuous data between groups,and the paired t- test was applied for comparison of continuous data within one group; the chi- square test was applied for comparison of categorical data between groups; the survival curve was used for survival analysis,and the log-rank test was applied for survival comparison. Results The indices of short- term outcome,objective response rate and disease control rate,showed no significant differences between the two groups. The 2- year survival showed a significant difference between the two groups( χ2=4. 692,P = 0. 03). The log- rank test showed that overall survival time and median progression- free survival time showed significant differences between the two groups( χ2= 8. 267 and 6. 896,P = 0. 004 and 0. 009). After treatment,alpha- fetoprotein( AFP) and gamma- glutamyl transpeptidase( GGT) showed significant differences between the two groups( t = 2. 035 and 2. 843,P = 0. 038 and 0. 025). The incidence rates of nausea / vomiting,dizziness / headache,rash / desquamation,and increased blood pressure showed significant differences between the two groups( all P < 0. 05). Conclusion TACE combined with thalidomide has the same short- term therapeutic effect as TACE combined with sorafenib and can improve the patient's long- term outcome and significantly reduce the levels of AFP and GGT,but it has high incidence of nausea / vomiting and dizziness / headache.
[1]BHAYANI NH,JIANG Y,HAMED O,et al.Advances in the pharmacologic treatment of hepatocellular carcinoma[J].Curr Clin Pharmacol,2015,10(4):299-304.
|
[2]GE JB,XU YJ.Internal medicine[M].8th.Beijing:People's Medical Publishing House,2013:429.(in Chinese)葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:429.
|
[3]YANG XF,LONG XD.Research advances in recurrence and metastasis of primary liver cancer[J].Henan J Surg,2012,18(2):80-83.(in Chinese)杨显富,龙先德.原发性肝癌复发转移的研究进展综述[J].河南外科学杂志,2012,18(2):80-83.
|
[4]YE YJ,SHEN ZL,WANG S.Therapeutic concept and strategy of metastatic liver cancer[J].Chin J Oper Proc Gen Surg:Electronic Edition,2014,8(1):26-29.(in Chinese)叶颖江,申占龙,王杉.转移性肝癌的治疗理念和策略[J].中华普外科手术学杂志:电子版,2014,8(1):26-29.
|
[5]Ministry of Health of the People's Republic of China.Diagnosis,management,and treatment of hepatocellular carcinoma(V2011)[J].J Clin Hepatol,2011,27(11):1141-1159.(in Chinese)中华人民共和国卫生部.原发性肝癌诊疗规范(2011年版)[J].临床肝胆病杂志,2011,27(11):1141-1159.
|
[6]GAO S,ZHU X,YANG RJ,et al.TACE combined with hepatic arterial infusion chemotherapy using oxaliplatin,5-fluorouracil and folinic acid for intermediate and advanced hepatocellular carcinomas[J].J Intervent Radiol,2012,21(5):377-383.(in Chinese)高嵩,朱旭,杨仁杰,等.TACE联合奥沙利铂、氟尿嘧啶、亚叶酸钙肝动脉化疗治疗中晚期原发性肝癌[J].介入放射学杂志,2012,21(5):377-383.
|
[7]DING J,DAI X,MENG XY,et al.Research advances in response evaluation criteria in solid tumors[J].Chin J Clin Oncol Rehabil,2015,22(9):1150-1152.(in Chinese)丁婕,戴旭,孟宪运,等.实体瘤疗效评价标准的研究进展[J].中国肿瘤临床与康复,2015,22(9):1150-1152.
|
[8]LAN CH,WANG CY.Progress of TACE for primary liver cancer[J].Curr Physician,2009,15(23):500-502.(in Chinese)兰春虎,王常友.原发性肝癌TACE治疗进展[J].当代医学,2009,15(23):500-502.
|
[9]COLOMBO M,SANGIOVANNI A.Treatment of hepatocellular carcinoma:beyond international guidelines[J].Liver Int,2015,35(1):129-138.
|
[10]LEY AM,CHAU CH,FIGG WD.Structural studies reveal thalidomide's mechanism of action and clinical effects:crystal clear or clearly complexed?[J].Cancer Biol Ther,2015,16(1):19-20.
|
[11]YU J,LIU F,SUN Z,et al.The enhancement of radiosensitivity in human esophageal carcinoma cells by thalidomide and its potential mechanism[J].Cancer Biother Radiopharm,2011,26(2):219-227.
|
[12]GIRGIS E,MAHONEY J,DARLING-REED S,et al.Arsenic trioxde enhance the cytotoxic effect of thalidomide in a KG-la human acute mylogenous leukemia cell line[J].Oncol lett,2010,1(3):473-479.
|
[13]PAN JQ,LU GP,YU ZJ.Thalidomide on anti-tumor research[J].Chin J Cancer Prev Treat,2012,19(7):552-555.(in Chinese)潘骥群,鲁光平,于志坚.沙利度胺抗肿瘤的研究进展[J].中华肿瘤防治杂志,2012,19(7):552-555.
|
[14]NISHIDA N,KITANO M,SAKURAI T,et al.Molecular mechanism and prediction of sorafenib chemoresistance in human hepatocellular carcinoma[J].Dig Dis,2015,33(6):771-779.
|
[15]ZHANG HJ,GUO WD.Research advances in sorafenib in treatment of tumors[J].Chin J Clinicians:Electronic Edition,2013,7(1):258-260.(in Chinese)张惠洁,郭卫东.索拉菲尼在肿瘤治疗中的研究进展[J].中华临床医师杂志:电子版,2013,7(1):258-260.
|
[16]YANG M,QI XS,HAN GH.Sorafenib-related adverse events in treatment of hepatocellular carcinoma[J].J Clin Hepatol,2014,30(3):278-281.(in Chinese)杨曼,祁兴顺,韩国宏.索拉菲尼在肝癌治疗中的不良反应[J].临床肝胆病杂志,2014,30(3):278-281.
|
[17]CHANG BX,XIN SJ.Recent advances in research on alpha-fetoprotein and its clinical application[J].World Chin J Dig,2010,18(6):576-580.(in Chinese)常彬霞,辛绍杰.甲胎蛋白及其临床应用研究进展[J].世界华人消化杂志,2010,18(6):576-580.
|
[18]ZENG YL,MAO HN.The relationship between changes and prognosis of serum AFP,AKP,GGT in hepatocellular carcinoma after transcatheter hepatic arterial chemoembolization[J].China Trop Med,2011,11(11):1389-1405.(in Chinese)曾颖玲,毛惠南.血清AFP、AKP和GGT在肝癌化疗栓塞后的改变与预后的关系[J].中国热带医学,2011,11(11):1389-1405.
|
[19]WAN XH,LU XF.Diagnostics[M].8th ed.Beijing:People's Medical Publishing House,2013:366-372.(in Chinese)万学红,卢雪峰.诊断学[M].8版.北京:人民卫生出版社,2013:366-372.
|