ABSTRACT
ObjectiveTo investigate the clinical effect of the targeted drug sunitinib in the treatment of advanced hepatocellular carcinoma (HCC). MethodsA total of 48 patients with advanced HCC who were admitted to Chang′an Hospital form September 2015 to September 2016 were enrolled and divided into control group and observation group, with 24 patients in each group. The patients in the control group were given oral sorafenib, and those in the observation group were given oral sunitinib. The patients were followed up for 1 year, and the clinical outcome, improvement in clinical symptoms, and adverse events were recorded. The t-test was used for comparison of continuous data between groups, and the Mann-Whitney U test was used for comparison of categorical data between groups. ResultsThe disease control rate (DCR) in the observation group was 68.42% (13/19), and among these 13 patients, 4 achieved effective remission and 9 had stable disease; the DCR in the control group was 76.19%, and there was no significant difference in DCR between the two groups (P＞0.05). There was a significant difference in the incidence rate of hand-foot skin reaction between the observation group and the control group (0% vs 12.5%, U=31.07, P＜0.05). The observation group had a significantly higher incidence rate of neutropenia than the control group (25% vs 16.67%, U=29.87, P＜0.05). Both groups experienced digestive tract reactions (nausea and vomiting) and abnormal liver function; since the digestive tract reactions were tolerable, no special treatment was given, and the patients with abnormal liver function were given liver-protecting drugs, so all adverse events were effectively alleviated. ConclusionSunitinib has a good clinical effect in the treatment of advanced HCC, and further studies with a larger sample size are needed to investigate the long-term clinical effect of sunitinib and combined treatment.
ABSTRACT
Objective To observe the clinical curative effet and survival condition of sorafenib for patients with advanced hepatocellular carcinoma.Methods Sixty-six patients with hepatocellular carcinoma during January 2013 to January 2015 in Chang'an Hospital were included.All patients were randomly divided into transcatheter arterial chemoembolization (TACE) group (n =33) and sorafenib + TACE group (n =33) according to the random digital table method.Followed up for 2 years,we observed the clinical curative effect,including 6-months survival rate,1-year survival rate,the changes of serum alpha fetoprotein level before and after the treatment,survival time and related adverse reactions.Results The disease control rate of sora-fenib + TACE group was 84.85％ (28/33),which was significantly higher than that of TACE group (60.61％,20/33),and the difference was statistically significant (x2 =4.889,P =0.027).The median survival time of patients with sorafenib +TACE group was 20.30 months,which was longer than that of TACE group (12.50 months),and the difference was statistically significant (x2 =29.570,P =0.000).The 6-months and 1-year survival rates in patients with sorafenib + TACE group were 93.93％ and 75.76％,respectively,which were significantly higher than those of TACE group (84.85％,51.52％).The rate of 1-year recurrence and metastasis of sorafenib + TACE group was 21.21％,which was lower than that of TACE group (39.39％),and the difference was statistically significant (x2 =2.908,P =0.041).After 6 months treatment,the serum level of alpha fetoprotein in patients with sorafenib + TACE group was (1 911.53 ± 457.86)ng/ml,which was signi-ficantly lower than that of TACE group [(2 979.83± 842.71)ng/ml],and the difference was statistically significant (t =11.996,P =0.001).The median survival time of patients with Child-Pugh A was significantly longer than that of patients with Child-Pugh B (20.50 months vs.13.95 months),with a significant difference (x2 =3.973,P =0.046).Patients in sorafenib + TACE group and TACE group had adverse reactions including nausea,vomiting and abnormal liver function,and there was significant difference in the incidence of untoward effects (87.88％ vs.60.61％;x2 =6.418,P =0.011).Conclusion The application of sorafenib the-rapy in the treatment of advanced hepatocellular carcinoma based on TACE can effectively improve the disease control rate,prolong the survival time of patients and improve the survival rate of patients.