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投稿时间：2024-12-04 网络发布日期：2026-03-04
投稿时间：2024-12-04 网络发布日期：2026-03-04
中文摘要: 目的 探讨索拉非尼联合经导管肝动脉化疗栓塞（TACE）及射频消融（RFA）对术后复发的肝细胞癌（HCC）患者的治疗效果，为临床选择合理干预方案提供参考。方法 选取2020年1月至2022年3月间在衡水市中医医院诊断及治疗的术后复发的HCC患者107例为研究对象，以随机数表法分为联合组（n=53）与对照组（n=54），对照组采用TACE联合RFA治疗，联合组在对照组治疗的基础上加用甲苯磺酸索拉非尼片400 mg/次，2次/d，直至HCC再次进展。比较两组患者临床疗效及治疗前后血清甲胎蛋白（AFP）、α-L-岩藻糖苷酶（AFU）及异常凝血酶原（APT）水平，采用 Kaplan-Meier 法绘制生存曲线比较两组患者 2 年生存情况。结果 联合组治疗客观缓解率显著高于对照组（83.02% vs 61.11%，χ2=6.363，P=0.012）；治疗前两组AFP、AFU 及APT 水平差异无统计学意义（P>0.05），治疗后 2、4、6 个月联合组 AFP、AFU 及 APT 均低于对照组（P<0.05）。随访 2 年，中位随访时间 16个月，截至末次随访，联合组和对照组中位总生存（OS）时间分别为20、16个月，中位无进展生存（PFS）时间分别为9.5、6个月。联合组患者2年OS率（log rank χ2=4.863，P=0.027）及PFS 率（log rank χ2=3.970，P=0.046）显著高于对照组。联合组和对照组不良反应发生率无差异无统计学意义（11.32% vs 3.70%，χ2=1.277，P=0.258）。结论 索拉非尼联合 TACE 和 RFA 在治疗 HCC 术后复发的效果显著，进一步延长患者生存期，并发症可控，能有效提高患者预后。
Abstract:Objective To explore the therapeutic effect of sorafenib combined with transcatheter arterial chemoembolization（TACE）and radiofrequency ablation（RFA）in patients with postoperative recurrent hepatocellular carcinoma（HCC），and to provide a reference for clinical selection of reasonable intervention plans. Methods A total of 107 patients with postoperative recurrent HCC diagnosed and treated in Hengshui Hospital of Traditional Chinese Medicine from January 2020 to March 2022 were selected as the research subjects. They were divided into the combination group（n=53）and the control group（n=54）by random number table method. The control group was treated with TACE combined with RFA，while the combination group was additionally given sorafenib tosylate tablets at a dose of 400 mg per time，twice a day，until the HCC progressed again. The clinical efficacy of the two groups was compared，as well as the serum levels of alpha-fetoprotein（AFP），α-L-fucosidase（AFU）and abnormal prothrombin（APT）before and after treatment. The Kaplan-Meier method was used to draw survival curves for comparing the 2- year survival status of the two groups.Results The Objective response rate of the combination group was significantly higher than that of the control group（83.02% vs 61.11%，χ2=6.363，P=0.012）. There were no statistically significant differences in the levels of AFP，AFU and APT between the two groups before treatment（P>0.05）. At 2，4 and 6 months after treatment，the levels of AFP，AFU and APT in the combination group were lower than those in the control group（P<0.05）. During the 2-year follow-up，the median follow - up time was 16 months. Up to the last follow - up，the median overall survival（OS）of the combination group and the control group was 20 months and 16 months，respectively，and the median progression-free survival（PFS）was 9.5 months and 6 months，respectively. The 2-year OS rate（log rank χ2=4.863，P=0.027）and PFS rate（log rank χ2=3.970，P=0.046）of the combination group were significantly higher than those of the control group.There was no statistically significant difference in the incidence of adverse reactions between the combination group and the control group（11.32% vs 3.70%，χ2=1.277，P=0.258）. Conclusion Sorafenib combined with TACE and RFA has a significant effect in the treatment of postoperative recurrent HCC，which can further prolong the survival of patients，control complications，and effectively improve the prognosis of patients.
keywords: Sorafenib Transcatheter arterial chemoembolization Radiofrequency ablation Hepatocellular carcinoma Postoperative recurrence Survival analysis
文章编号： 中图分类号：R735.7 R453.9 文献标志码：A
基金项目:河北省医学科学研究计划项目（20232201）
附件
| 作者 | 单位 |
| 蔡佳梦 | 1. 衡水市中医医院影像科, 河北 衡水 053000 |
| 李梦迪 | 2. 衡水市中医医院中医科, 河北 衡水 053000 |
| 王仁平 | 3. 衡水市第五人民医院中医科, 河北 衡水 053000 |
| 杜春海 | 4. 衡水市中医医院肿瘤科, 河北 衡水 053000 |
| Author Name | Affiliation |
| CAI Jiameng*，LI Mengdi，WANG Renping，DU Chunhai | *Department of Radiology,Hengshui Hospital of Traditional Chinese Medicine,Hengshui,Hebei 053000,China |
引用文本：
蔡佳梦,李梦迪,王仁平,等.索拉非尼联合经导管肝动脉化疗栓塞及射频消融治疗肝细胞癌术后复发的效果[J].中国临床研究,2026,39(2):205-210.
蔡佳梦,李梦迪,王仁平,等.索拉非尼联合经导管肝动脉化疗栓塞及射频消融治疗肝细胞癌术后复发的效果[J].中国临床研究,2026,39(2):205-210.