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Eur J Cancer:采用顺铂或表柔比星进行动脉化疗栓塞治疗肝癌的疗效

2021-10-06 Nebula MedSci原创

采用顺铂进行动脉化疗栓塞治疗肝细胞癌的效果没有显著优于表柔比星

经动脉化疗栓塞 (TACE) 是肝细胞癌 (HCC) 的一种治疗选择,但TACE的最佳药物目前仍不明确。在该研究中,研究人员对比了采用顺铂 vs 表柔比星进行TACE治疗不可切除的肝癌患者中的疗效。

这是一项在日本的21家医院开展的多中心、随机的2/3期试验,表现状态 0-2 分的、Child-Pugh A/B级的确诊的肝细胞癌患者被随机分成了两组,接受顺铂或表柔比星进行TACE;并根据机构、Child-Pugh分级、肿瘤大小、瘤栓、甲胎蛋白和既往治疗分层。主要终点是总生存期。

研究流程

2008年至2012年期间,共有455位患者被随机分至顺铂组(n=228)或表柔比星组(n=227)。11位患者随后因审查不符合要求被排除分析,最终分析纳入了444位患者。12位未进行TACE治疗的患者被排除安全性分析。

在2期研究中,顺铂组(91.7%)和表柔比星组(91.8%)的疾病控制率均超过了预期阈值(70%),顺利进入3期研究。

两组的总生存期

中位随访了32.7个月后,顺铂组和表柔比星组的中位总生存期分别是2.93年(95% CI 2.60-3.79)和2.74年(2.26-3.21;风险比 0.90, 95% CI 0.71-1.15; p=0.22)。顺铂组和表柔比星组治疗失败前的中位时间分别是1.38年和1.46年(风险比 1.09, 95% CI 0.88-1.35; p=0.88),缓解率分别是65.3%和60.6%(p=0.31)。

治疗失败率

顺铂组和表柔比星组的严重不良事件发生率分别是49.8%和48.3%(p=0.56)。两组均无治疗相关死亡事件。

综上所述,在该2/3期研究中,采用顺铂进行TACE治疗肝细胞癌的效果没有显著优于表柔比星

原始出处:

Aramaki Osamu,Takayama Tadatoshi,Moriguchi Masamichi et al. Arterial chemoembolisation with cisplatin versus epirubicin for hepatocellular carcinoma (ACE 500 study): A multicentre, randomised controlled phase 2/3 trial.[J] .Eur J Cancer, 2021, 157: 373-382. https://doi.org/10.1016/j.ejca.2021.08.027

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    2021-10-07 查查佳佳

    买裤子里边天气丹丹

    0

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    2021-10-07 胖胖的瘦子

    学习中

    0

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