Haohao Lu, Bin Liang, Xiangwen Xia, Chuansheng Zheng
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引用次数: 0
摘要
目的：旨在评估PTCD联合TACE治疗伴有梗阻性黄疸的肝细胞癌的安全性和有效性，并比较TACE对PTCD后胆红素水平不同的患者的疗效：方法：回顾性分析141例合并梗阻性黄疸的HCC患者的临床资料。患者首先接受 PTCD。当总胆红素下降时，患者接受 TACE 或阿帕替尼治疗。他们被分为两组：（1）PTCD+TACE组，N=68；（2）PTCD+阿帕替尼组，N=73：结果：PTCD+TACE组的ORR和DCR均高于PTCD+阿帕替尼组（57.4% vs 12.3%，P < 0.001；80.9% vs 60.3%，P = 0.010）。PTCD+TACE组的mPFS长于PTCD+阿帕替尼组（7.1个月 vs 3.8个月，p < 0.001）。PTCD+TACE组的mOS时间长于PTCD+阿帕替尼组（11.5个月 vs 7.7个月，P < 0.001）。在PTCD+TACE组的亚组分析中，结果显示总胆红素Conclusion组的生存获益更多：在HCC和梗阻性黄疸患者中，使用PTCD将总胆红素降至3倍后，超选择性TACE（脂碘醇+表柔比星乳剂）与阿帕替尼相比，能显著延长OS和PFS。
Efficacy Analysis of PTCD + TACE vs PTCD + Apatinib in the Treatment of HCC with Obstructive Jaundice: A Retrospective Study.
Purpose: The aim was to evaluate the safety and effectiveness of PTCD combined with TACE in the treatment of hepatocellular carcinoma with obstructive jaundice and to compare the efficacy of TACE in patients with different levels of bilirubin after PTCD.
Methods: The clinical data of 141 patients with HCC complicated with obstructive jaundice were analyzed retrospectively. The patients underwent PTCD first. When the total bilirubin decreased, the patients received TACE or Apatinib treatment. They were divided into two groups: (1) PTCD+TACE group, N=68; (2) PTCD+Apatinib group, N=73.
Results: The PTCD+TACE group had higher ORR and DCR than the PTCD+Apatinib group (57.4% vs 12.3%, p < 0.001;80.9% vs 60.3%, p = 0.010). The mPFS of the PTCD+TACE group was longer than that of the PTCD+Apatinib group (7.1 months vs 3.8 months, p < 0.001). The mOS of the PTCD+TACE group was longer than that of the PTCD+Apatinib group(11.5 months vs 7.7 months, p < 0.001). In the subgroup analysis of the PTCD+TACE group, the results showed that the survival benefits of the groups with total bilirubin <2 times and 2-3 times were greater.
Conclusion: In patients with HCC and obstructive jaundice, superselective TACE(lipiodol+epirubicin emulsion) significantly prolonged OS and PFS compared with Apatinib after using PTCD to reduce total bilirubin to <100umol/L. Patients whose total bilirubin dropped to ≤3 times of the upper limit of normal value after PTCD had longer OS and PFS than patients >3 times.
期刊介绍：
Formerly: Current Medicinal Chemistry - Anti-Cancer Agents.
Anti-Cancer Agents in Medicinal Chemistry aims to cover all the latest and outstanding developments in medicinal chemistry and rational drug design for the discovery of anti-cancer agents.
Each issue contains a series of timely in-depth reviews and guest edited issues written by leaders in the field covering a range of current topics in cancer medicinal chemistry. The journal only considers high quality research papers for publication.
Anti-Cancer Agents in Medicinal Chemistry is an essential journal for every medicinal chemist who wishes to be kept informed and up-to-date with the latest and most important developments in cancer drug discovery.
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