| 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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| 摘要点击次数: 1661 |
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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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