| Jingyan Wang,Linzhi Zhang,Xiaoming Peng,Yun Zhao,Lin Zhou. Combination of TACE and FOLFOX4 in the treatment of unresectable advanced hepatocellular carcinoma: a prospective cohort study. Oncol Transl Med, 2020, 6: 208-216. |
| TACE联合FOLFOX4方案治疗进展期肝癌的前瞻性研究 |
| Combination of TACE and FOLFOX4 in the treatment of unresectable advanced hepatocellular carcinoma: a prospective cohort study |
| Received:April 10, 2020 Revised:October 12, 2020 |
| DOI：10.1007/s10330-020-0417-7 |
| 中文关键词: 进展期肝癌；TACE；FOLFOX4 |
| 英文关键词: advanced hepatocellular carcinoma; transcatheter arterial chemoembolization (TACE); FOLFOX4 |
| 基金项目:军队医学科技青年培育项目（No.15QNP085） |
| Author Name | Affiliation | E-mail | | Jingyan Wang | The Fifth Medical Center of PLA General Hospital | wangjingyan.yan@163.com | | Linzhi Zhang | The Fifth Medical Center of PLA General Hospital | | | Xiaoming Peng | The Fifth Medical Center of PLA General Hospital | | | Yun Zhao | The Fifth Medical Center of PLA General Hospital | | | Lin Zhou* | The Fifth Medical Center of PLA General Hospital | lindagery302@163.com |
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| 中文摘要: |
| 目的 进展期肝癌的患者生存期短，经济有效的治疗方案很少。本研究对进展期肝癌患者进行TACE联合FOLFOX4方案治疗，探讨该方案的有效性与安全性。方法 纳入自2015年11月到2017年10月期间，明确诊断进展期肝癌的患者63例，所有患者常规行TACE治疗，其中33例治疗组患者在TACE术后给予FOLFOX4辅助化疗。随访截止到2019年4月30日或者患者死亡，用SPSS23.0分析两组患者的中位生存期（OS）、无进展生存期（PFS）、客观缓解率（ORR）、疾病控制率（DCR）以及药物毒副反应情况。结果 中位随访时间9.2（3-18）个月。TACE+FOLFOX4联合治疗组3个月的疾病控制率（DCR）为60.6%，中位OS为9.1个月（95%可信区间[CI]6.5-11.7）。TACE组DCR和OS分别为33.3%和5.5个月（95%CI 4.3-6.7），两组比较有显著性差异（P<0.05）。同时，联合组和TACE组PFS分别为5.6个月（95%CI 3.6-7.6）和2.6个月（95%CI 2.0-3.2），差异有统计学意义（P=0.01）。两组患者TACE相关不良事件相似。在联合治疗组中，FOLFOX4相关的不良反应常见，包括恶心（90.9%）、白细胞减少（75.8%）、血小板减少（69.7%）和呕吐（69.7%）。不良反应多为I-III级，经对症治疗后均可缓解。
结论 与单独TACE方案相比，TACE联合FOLFOX4方案治疗进展期肝癌具有较好的有效性和安全性，可作为进展期肝癌可选择的治疗方案之一。 |
| 英文摘要: |
| Objective: The aim of the study was to assess the effectiveness and safety of a combined therapy with
transcatheter arterial chemoembolization (TACE) and FOLFOX4, in patients with unresectable advanced
hepatocellular carcinoma (HCC).
Methods: In this study, patients with advanced HCC, that received treatment between November 2015
and October 2017, were recruited. Among these, 30 patients were treated with TACE only (TACE group);
whereas 33 patients were treated with a combination of FOLFOX4 chemotherapy and TACE (combination
group). Survival analyses, including overall survival (OS) and progression free survival (PFS) analysis,
were performed for both groups. Following this, the responses of patients to treatment were evaluated
every 3 months, and the toxic and adverse events were observed.
Results: The median follow-up time was 9.2 months (3–36 months). In the combination group, at 3
months, a disease control rate (DCR) of 60.6%, and a median OS of 9.1 months was obtained [95%
confidence interval (CI) 6.5–11.7]. In the TACE group, the DCR and OS were 33.3% and 5.5 months (95%
CI 4.3–6.7), respectively. On the other hand, the PFS in the combination and TACE groups were observed
as 5.6 months (95% CI 3.6–7.6) and 2.6 months (95% CI 2.0–3.2), respectively. Both these findings
indicate a statistically significant difference (P = 0.01) between both the groups. Similar TACE associated
adverse events were observed in both groups. In the combination group, frequently observed FOLFOX4
related adverse effects included nausea (90.9%), leukopenia (75.8%), thrombocytopenia (69.7%), and
vomiting (69.7%). Most adverse reactions were between grades I–III and were alleviated after symptomatic
treatments.
Conclusion: The combination of TACE with FOLFOX4 therapy has better effectivity and safety than
TACE alone. |
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