冯 跃,郑家平,邵国良.索拉非尼治疗肝细胞癌肺转移39例预后分析[J].肿瘤学杂志,2018,24(10):987-991. |
索拉非尼治疗肝细胞癌肺转移39例预后分析 |
Related Factors to Survival of Advanced Hepatocellular Carcinoma Patients with Lung Metastasis Receiving Sorafenib Therapy |
投稿时间:2017-05-09 |
DOI:10.11735/j.issn.1671-170X.2018.10.B010 |
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中文关键词: 癌,肝细胞 肺转移瘤 索拉非尼 |
英文关键词:carcinoma,hepatocellular lung metastasis sorafenib |
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中文摘要: |
摘 要:[目的] 评估索拉非尼治疗晚期肝细胞癌肺转移的临床疗效,分析其预后影响的因素。[方法] 回顾性分析39例肝细胞癌肺转移患者的临床资料。采用RECIST 标准进行近期疗效评价,Kaplan-Meier法统计中位肿瘤进展时间(mTTP)及中位总生存期(mOS),并记录不良事件。选取性别、年龄、PS评分、肝功能Child-Pugh分级、甲胎蛋白(AFP)定量水平、肝脏肿瘤类型、肺外转移、肺部转移瘤负荷大小、肺转移控制、肝脏原发灶控制、索拉非尼相关3级以上不良反应事件等11个指标建立Cox回归模型,分析上述指标对患者OS的影响。[结果] 39例患者均可作疗效评价,死亡32例(肿瘤进展28例,3例肝功能衰竭,1例脑出血),存活7例。肺转移瘤疾病控制率(DCR)为53.8%(21/39),其中CR 2例,PR 4例,SD 15例,PD 18例,mTTP为6.692个月(95%CI:3.864~9.521),mOS为12.359个月(95%CI:9.641~15.077)。单因素分析显示,Child-Pugh评分(P=0.017)、肺部肿瘤负荷(P=0.011)、肝脏原发灶控制(P=0.001)、肺部转移瘤控制(P=0.001)4项指标与预后相关。多因素分析显示,肝脏原发灶和肺部转移瘤控制为独立的预后影响因素(P<0.05)。[结论] 索拉非尼治疗晚期肝癌肺转移安全、有效,积极控制肝脏原发灶、肺部转移瘤可延长生存时间。 |
英文摘要: |
Abstract:[Objective] To analyze the survival-related factors in advanced hepatocellular carcinoma(HCC) patients with lung metastasis receiving sorafenib therapy. [Methods] The clinical data of 39 HCC patients with lung metastasis confirmed by pathology or clinical diagnosis receiving sorafenib targeted therapy were analyzed retrospectively. The short-term response was assessed based on RECIST. The mean time to tumor progression(mTTP),mean overall survival(mOS),and adverse events were documented. Eleven factors including gender,age,PS score,Child-Pugh score,level of AFP,liver tumor type,ex-lung metastasis,burden of lung tumors,liver tumor control,lung tumor control,and severe adverse events(SAE) related with sorafenib were added to COX harzard model and analyzed. [Results] Among 39 patients 7 survived and 32 died or lost of follow-up. The disease control rate(DCR) were 53.8%,mTTP was 6.692 months(95%CI:3.864~9.521),mOS was 12.359 months(95%CI:9.641~15.077). Univariate analysis showed that low Child-Pugh(CP) score(P=0.017),small burden of lung tumor(P=0.011),controlled liver tumor and lung tumor were significantly associated with longer OS. Multivariate analysis showed that controlled liver tumor and lung tumor was independent prognostic factor of patients(P<0.05). [Conclusion] Controlled liver primary tumor and lung metastatic tumor is the favorable factor associated with the survival of advanced hepatocellular carcinoma patients with lung metastasis receiving sorafenib treatment. |
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