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乙型肝炎病毒相关的肝细胞癌患者行经动脉化疗栓塞术同时服用核苷(酸)类似物可以提高生存率

作者: 丁胜楠 发布日期: 2012-03-22 阅读次数:
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 目的:明确乙型肝炎病毒(HBV)相关性肝细胞癌(HCC)患者化疗栓塞术联合核苷类似物治疗与单独化疗栓塞术相比是否可以提高生存率。方法:设计了一个关于HBV相关性原发性肝癌患者的回顾性研究来分析单用化疗栓塞术病人的情况。相关的统计学和临床数据被引用和记录。通过使用Kaplan-Meier乘积极限法估算生存函数来确定核苷()类似物(拉米夫定、阿德福韦酯或者恩替卡韦)对治疗的影响。结果:81名患者满足化疗栓塞术纳入标准 (67个男性和14个女性,平均年龄60.6岁±9.2),其中21(25.9%)患者已经应用核苷类似物治疗。与未接受核苷()类似物(1.82±0.95;P = .0022)治疗的患者相比接受核苷()类似物(3.43±2.32)治疗的患者化疗栓塞治疗的人数显著增加。患者1年、3年、5年生存率服用核苷类似物治疗的患者分别为89.5%,66.8%40.5%,未服用核苷()类似物的患者分别为72.6%27.5%14.3%。服用核苷()类似物患者的生存率显著升高(P = .0051)。核苷类似物的摄入是提高生存率的一个独立因素 (P = .0063) 结论HBV相关性肝细胞癌患者给予化疗栓塞术联合核苷()类似物治疗可提高生存率。

 

吉林大学第一医院肝胆胰内科  丁胜男  摘译

本文首次发表于[J Vasc Interv Radiol. 2012 Mar;23(3):317-322.el. Epub 2012 Jan 21.]

 

 

Transarterial Chemoembolization for Hepatitis B Virus-associated Hepatocellular Carcinoma: Improved Survival after Concomitant Treatment with Nucleoside Analogues

 

Abstract

BACKGROUND & AIMS:

To determine whether nucleoside analogue therapy is associated with improved survival in patients with hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC) who are treated solely with transarterial chemoembolization.

MATERIALS AND METHODS:

A retrospective chart review of patients diagnosed with HBV-associated HCC was performed to identify patients treated solely with chemoembolization. Relevant demographic and clinical data were extracted and recorded. The influence of therapy with nucleoside analogues (lamivudine, adefovir dipivoxil, or entecavir) was determined by estimating the survival function using the Kaplan-Meier product-limit method.

RESULTS

The inclusion criteria for chemoembolization were met by 81 patients (67 men and 14 women, mean age 60.6 years ± 9.2); 21 (25.9%) of these patients had been treated with nucleoside analogues. The number of chemoembolization treatments was significantly greater in the patients who were treated with nucleoside analogues (3.43 ± 2.32) than in the patients who did not receive nucleoside analogues (1.82 ± 0.95; P = .0022). The 1-year, 3-year, and 5-year survival rates were 89.5%, 66.8%, and 40.5% in the patients treated with nucleoside analogues and 72.6%, 27.5%, and 14.3% in the patients not treated with nucleoside analogues. The survival rate was significantly higher in the patients who received nucleoside analogues (P = .0051). Nucleoside analogue intake was an independent factor that was associated with increased survival (P = .0063).

CONCLUSION:

Administration of nucleoside analogues was associated with longer survival in patients with HBV-associated HCC who were treated with transarterial chemoembolization.


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作者: 丁胜楠 发布日期: 2012-03-22 阅读次数: