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立体定向放疗序贯仑伐替尼治疗中晚期原发性肝癌的效果与安全性分析

纪晓权 张爱民 张弢 李文刚 何卫平 孙静 段学章

纪晓权, 张爱民, 张弢, 等. 立体定向放疗序贯仑伐替尼治疗中晚期原发性肝癌的效果与安全性分析[J]. 临床肝胆病杂志, 2021, 37(9): 2120-2124. DOI: 10.3969/j.issn.1001-5256.2021.09.023
引用本文: 纪晓权, 张爱民, 张弢, 等. 立体定向放疗序贯仑伐替尼治疗中晚期原发性肝癌的效果与安全性分析[J]. 临床肝胆病杂志, 2021, 37(9): 2120-2124. DOI: 10.3969/j.issn.1001-5256.2021.09.023
JI XQ, ZHANG AM, ZHANG T, et al. Efficacy and safety of sequential lenvatinib therapy after stereotactic body radiotherapy in treatment of advanced primary liver cancer[J]. J Clin Hepatol, 2021, 37(9): 2120-2124. DOI: 10.3969/j.issn.1001-5256.2021.09.023
Citation: JI XQ, ZHANG AM, ZHANG T, et al. Efficacy and safety of sequential lenvatinib therapy after stereotactic body radiotherapy in treatment of advanced primary liver cancer[J]. J Clin Hepatol, 2021, 37(9): 2120-2124. DOI: 10.3969/j.issn.1001-5256.2021.09.023

立体定向放疗序贯仑伐替尼治疗中晚期原发性肝癌的效果与安全性分析

DOI: 10.3969/j.issn.1001-5256.2021.09.023
详细信息
    通讯作者:

    段学章,duanxuezhang2006@163.com

  • 中图分类号: R735.7

Efficacy and safety of sequential lenvatinib therapy after stereotactic body radiotherapy in treatment of advanced primary liver cancer

  • 摘要:   目的  探讨立体定向放射治疗(SBRT)序贯仑伐替尼治疗中晚期原发性肝癌的效果与安全性。  方法  选取2018年10月—2019年5月解放军总医院第五医学中心收治的18例中晚期原发性肝癌行SBRT联合仑伐替尼治疗患者。其中,BCLC B期4例,C期14例。给予计划靶区处方剂量48~55 Gy,中位值50 Gy,分6~10次,单次剂量中位值6(5~9)Gy/次。完成SBRT 1周后开始口服仑伐替尼治疗,用药中位时间为9.5(3.6~25.8)个月。治疗后前3个月,每月随访1次。治疗3个月后,每3个月随访1次。采用Kaplan-Meier法计算总生存、无进展生存、局部控制率,观察不良反应和并发症发生率。  结果  随访至2020年11月30日,共有8例患者死亡,其中3例因肝衰竭死亡,3例因肿瘤进展死亡,1例因胆囊穿孔死亡,1例因消化道出血死亡。治疗开始后3、6、9、12、18个月的总生存率分别为100%、94%、83%、72%、67%,无进展生存率分别为100%、67%、50%、22%、17%,局部控制率为100%、94%、94%、94%、94%,其中中位总生存期>18个月,中位无进展生存期为9个月。1例(6%)患者SBRT过程中出现3级不良反应,2例(11%)患者仑伐替尼治疗过程中出现3级不良反应,未发生致命性不良反应。  结论  初步证实SBRT序贯仑伐替尼是中晚期原发性肝癌有效、安全的治疗方法。

     

  • 图  1  累积生存率

    图  2  无进展生存率

    表  1  SBRT和仑伐替尼治疗不良反应

    项目 SBRT[例(%)] 服用仑伐替尼[例(%)]
    1~2级 3级 4~5级 1~2级 3级 4~5级
    纳差 3(17) 0 0 0 0 0
    恶心 3(17) 1(6) 0 0 0 0
    呕吐 0 1(6) 0 0 0 0
    高血压 0 0 0 6(33) 0 0
    蛋白尿 0 0 0 3(17) 0 0
    腹痛 0 0 0 2(11) 1(6) 0
    腹泻 0 0 0 1(6) 1(6) 0
    体质量下降 0 0 0 2(11) 0 0
    疲乏 0 0 0 2(11) 0 0
    腹胀 0 0 0 1(6) 0 0
    下载: 导出CSV
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  • 收稿日期:  2021-02-01
  • 修回日期:  2021-05-10
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