肝动脉灌注化疗联合卡瑞利珠单抗和仑伐替尼治疗肝癌合并VP3/4型门静脉癌栓的近期疗效与安全性  

Short-term Efficacy and Safety of Hepatic Arterial Infusion Chemotherapy Combined with Carrelizumab and Lenvatinib in Hepatocellular Carcinoma with Portal Vein Tumor Thrombus(VP3/4)

作　　者：徐永康 付舒敏 李丹 毛野 吴建兵[1] XU Yong-kang;FU Shu-min;LI Dan;MAO Ye;WU Jian-bing(Department of Oncology,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院肿瘤科,南昌333006

出　　处：《南昌大学学报（医学版）》2022年第5期32-37,共6页Journal of Nanchang University：Medical Sciences

基　　金：国家自然科学基金地区项目(82060435);南昌大学第二附属医院临床研究项目(2021efyC07)。

摘　　要：目的探讨肝动脉灌注化疗(HAIC)联合卡瑞利珠单抗和仑伐替尼治疗肝癌合并VP3/4型门静脉癌栓的近期疗效及安全性。方法对南昌大学第二附属医院2020年8月至2021年8月收治的19例采用HAIC联合卡瑞利珠单抗和仑伐替尼治疗的肝癌合并VP3/4型门静脉癌栓患者的临床资料进行回顾性分析,观察其近期疗效和安全性。结果按改良的实体瘤疗效评价标准(mRECIST),19例患者总体疗效客观缓解率及疾病控制率分别为63.1%、78.9%,肝内病灶客观缓解率及疾病控制率分别为68.4%、78.9%;按实体瘤疗效评估标准1.1版(RECIST1.1),19例患者总体疗效客观缓解率及疾病控制率分别为26.3%、68.4%,肝内病灶客观缓解率及疾病控制率分别为26.3%、73.7%。首次联合治疗后患者血清白蛋白(ALB)较术前显著降低(P<0.05),而总胆红素(TBIL)、直接胆红素(DBIL)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)较术前升高,但差异无统计学意义(P>0.05)。最常见的不良反应事件包括中性粒细胞减少(57.9%)、血小板减少(52.6%)、腹痛(42.1%),3级不良反应发生率为15.8%(3/19)。结论对于肝癌合并VP3/4型门静脉癌栓患者,HAIC联合卡瑞利珠单抗和仑伐替尼治疗是有效且安全的。Objective To investigate the short-term efficacy and safety of hepatic artery infusion chemotherapy(HAIC)combined with carrelizumab and lenvatinibin the treatment of hepatocellular carcinoma with major portal vein tumor thrombosis(VP3/4).Methods The clinical data of 19 patients treated with HAIC combined with carrelizumab and lenvatinib for hepatocellular carcinoma with major portal vein tumor thrombosis(VP3/4)in the Second Affiliated Hospital of Nanchang University from August 2020 to August 2021 were analyzed retrospectively.The short-term efficacy and safety were observed.Results According to the modified Response Evaluation Criteria in Solid Tumors(RECIST),the overall response rate and disease control rate among the 19 patients were 63.1%and 78.9%(RECIST version 1.1,26.3%and 68.4%),respectively.The objective remission rate and disease control rate of intrahepatic lesions were 68.4%and 78.9%(RECIST version 1.1,26.3%and 73.7%),respectively.The serum concentration of albumin was significantly decreased after the first combined treatment(P<0.05).Although the postoperative levels of total bilirubin,direct bilirubin,aspartate aminotransferase and alanine aminotransferase were increased compared with those before operation,the differences were not obvious(P>0.05).The most common adverse events included neutropenia(57.9%),thrombocytopenia(52.6%),and abdominal pain(42.1%).The incidence of grade 3 adverse reactions was 15.8%(3/19).Conclusion The combined treatment with HAIC,carrelizumab and lenvatinibis effective and safe for hepatocellular carcinoma with major portal vein tumor thrombosis(VP3/4).

关 键 词：肝动脉灌注化疗 卡瑞利珠单抗 仑伐替尼 门静脉癌栓 肝癌 近期疗效 安全性 

分 类 号：R735.7[医药卫生—肿瘤]