【摘要】

目的：探讨靶向药物索拉非尼联合立体定向放射治疗肝癌肺转移的临床疗效及安全性。
方法：选取2013年1月~2015年1月于我科就诊的肝癌肺转移患者56例，采用数字随机法，均分为观察组（n=28）与对照组（n=28），对照组患者给予立体定向放疗，观察组患者在此基础上给予靶向药物索拉非尼治疗，对比两组患者的临床疗效及安全性。
结果：观察组患者的治疗总有效率显著高于对照组（P<0.05），1年、2年生存率显著高于对照组（P<0.05），中位生存期显著长于对照组（P<0.05）；治疗期间两组均有不同程度的不良反应，包括乏力、恶心、食欲下降、骨髓抑制等；观察组不良反应发生率为78.57%（22/28），对照组不良反应发生率为85.71%（24/28）。两组患者的不良反应发生率对比差异不显著，无统计学意义（=1.737，P>0.05）。在治疗后2月，观察组NK细胞（71.43%）和IL-2（78.57%）总有效率显著高于对照组（39.29%、46.43%），差异有统计学意义（P＜0.05），表明观察组患者的免疫力改善状况优于对照组。
结论：靶向药物索拉非尼联合立体定向放射治疗肝癌肺转移的临床疗效好，能够有效延长患者的中位生存期，不良反应轻微，具有推广价值。

【Abstract】

Objective: To explore the clinical efficacy and safety of targeted drugs sorafenib combined with stereotactic radiotherapy for lung metastasis of liver cancer.
Methods: January 2013 ~2015 year in January in our hospital of liver cancer patients with pulmonary metastases in 56 cases, were randomly divided into observation group, (n=28) and control group (n=28), the control group were treated with stereotactic radiotherapy, the patients in the observation group were given on the basis of drug targeting cable Rafini treatment, clinical efficacy and safety comparison of two groups of patients.
Results:The observation group the total efficiency was significantly higher than the control group (P<0.05), 1 years, 2 years survival rate was significantly higher than the control group (P<0.05), the median survival period was significantly longer than that of the control group (P<0.05); adverse reactions during the treatment of the two groups were specific difference in different degree, including fatigue, nausea, loss of appetite and bone marrow suppression; the incidence of adverse reactions was 78.57% (22/28), the control group adverse reaction rate was 85.71% (24/28) bone marrow suppression control group two groups of patients with adverse reaction incidence compared no significant difference, no statistical significance (=1.737, P>0.05). After treatment, the observation group of NK cells (71.43%) and IL-2 (78.57%) the total effective rate was significantly higher than that of the control group (39.29%, 46.43%), the difference was statistically significant (P < 0.05), showed that the patients in the observation group than the control group in improving immunity.
Conclusion  :The clinical efficacy of targeted drugs sorafenib combined with stereotactic radiotherapy for lung metastasis of liver cancer is good, can effectively prolong the median survival time, adverse reactions were mild, with the promotion of value.