TACE combined with little dose Apatinib in treatment of hepatcellular carcinoma with portal vein thrombus / 中国介入影像与治疗学

ABSTRACT

Objective: To observe the value of TACE combined with little dose Apatinib in treatment of hepatcellular carcinoma (HCC) with portal vein thrombi. Methods: Totally 90 unrectable HCC patients with portal vein thrombi were randomly divided into treatment group and control group. Patients in treatment groups (n=38) were started oral little Apatinib 250 mg/d from 3 days after TACE. Patients in control group (n=52) were only underwent TACE. Postoperaion follow up was performed. The level of alpha fetal protein (AFP), survival time difference and response efficacy rate between 2 groups were compared. The postoperation untoward effects were also analyzed between 2 groups. Results: The operation sucess rates were both 100% in both groups. The AFP level of preoperation between 2 groups had no significant difference (t=20.15, P=0.08). The levels of AFP in treatment group postoperation 1 month, 3 months, 6 months, 12 months and 24 months were obviously decreased than those in control group (all P<0.05). The response efficacy rates in treatment group postoperation 1 month, 3 months, 6 months, 12 months and 24 months were 89.47%(34/38), 84.21%(32/38), 78.95%(30/38), 34.21%(13/38) and 10.53%(4/38), respectively; while those in control group were 75.00%(39/52), 67.31%(35/52), 25.00%(13/52), 3.85%(2/52) and 19.23%(10/52), respectively. The mean life time in treatment group was longer than that in control group ([17.12±1.55] months vs [14.21±2.13] months, P=0.01). Although the occurrence rates of hand-foot syndrome, erythra, diarrhoea, abdominal pain, gastrointestinal bleeding, proteinuria, haematuria, high creatinine and urea nitrogen, vertigo, headache, hypertention, erythropenia, leukopenia, low haemoglobin, low platelet, high transaminase, high bilrubin in treatment group were obviously more than control group (all P<0.01), most of them were lower than 3 grade according to the evaluation stantard of National Cancer Institute (NCI). Conclusion: TACE combined with little dose Apatinib are superior to single TACE in treatment of HCC with portal vein thrombi which can effectively prolong median lifetime.