经肝动脉化疗栓塞联合程序性死亡受体1抑制剂治疗晚期肝癌的临床研究  

Clinical study of TACE combined with PD-1 inhibitor in the treatment of advanced liver cancer

作　　者：韩萍 张志勇[2] 王兴东[2] 李正果 Han Ping;Zhang Zhiyong;Wang Xingdong;Li Zhengguo(Department of Radiology,Gansu Cancer Hospital,Gansu Lanzhou 730050,China;Department of Interventional Therapy,Gansu Cancer Hospital,Gansu Lanzhou 730050,China)

机构地区：[1]甘肃省肿瘤医院放射科,甘肃兰州730050 [2]甘肃省肿瘤医院介入治疗科,甘肃兰州730050

出　　处：《中国医刊》2023年第2期187-191,共5页Chinese Journal of Medicine

基　　金：甘肃省科学技术厅创新基地和人才计划自然科学基金项目(21JR1RA374)。

摘　　要：目的 探讨经肝动脉化疗栓塞(transhepatic arterial chemoembolization,TACE)联合程序性死亡受体1(programmed deathreceptor1,PD-1)抑制剂治疗晚期肝癌的临床疗效。方法 选择2020年4月至2022年1月甘肃省肿瘤医院收治的80例晚期肝癌患者,采用随机数字表法分为两组,每组40例。对照组采用TACE治疗,观察组采用TACE联合PD-1抑制剂治疗。比较两组的实体瘤疗效、安全性、生存时间,以及治疗前和治疗2个周期后血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、甲胎蛋白(alpha fetal protein,AFP)水平。结果 观察组疾病控制率(75.00%)高于对照组(52.50%),差异有显著性(P<0.05)。两组治疗2个周期后血清VEGF、AFP水平均较治疗前降低,且观察组低于对照组,差异有显著性(P<0.05)。两组Ⅲ度及以上不良反应发生率比较差异无显著性(P>0.05)。80例患者的随访时间为13(1,22)个月,观察组无进展生存时间为7(5,13)个月,长于对照组的5(3,10)个月,差异有显著性(P<0.05)。观察组总生存时间为15(15,22)个月,与对照组的14(13,21)个月比较差异无显著性(P>0.05)。结论 TACE联合PD-1抑制剂治疗晚期肝癌可降低血清VEGF和AFP水平,提高疾病控制率,延长无进展生存时间,且安全性可控。Objective To investigate the clinical efficacy of transhepatic arterial chemoembolization(TACE) combined with programmed death receptor 1(PD-1) inhibitor in the treatment of advanced hepatocellular carcinoma, and to provide theoretical basis for clinical treatment. Method Eighty patients with advanced liver cancer admitted to our hospital from April 2020 to January 2022 were randomly divided into two groups with 40 patients in each group. The control group was treated with TACE, and the observation group was treated with TACE combined with PD-1 inhibitor. The efficacy, safety, survival time, and serum VEGF and AFP levels were compared between the two groups. Result The DCR rate of observation group was higher than that of control group(75.00% vs 52.50%, P<0.05). After 2cycles of treatment, the levels of serum VEGF and AFP in both groups were lower than those before treatment(P<0.05), and the levels of serum VEGF and AFP in the observation group were lower than those in the control group(P<0.05). There was no significant difference in the incidence of Ⅲ degree or above adverse reactions between the two groups(P>0.05). The median follow-up of 80 patients was 13(1,22) months. The median progression-free survival time of the observation group was 7(5, 13) months, longer than that of the control group 5(3, 10) months(P<0.05). The median overall survival time of the observation group was 15(15, 22) months,there was no significant difference compared with 14(13, 21) months in the control group(P>0.05). Conclusion TACE combined with PD-1 inhibitor can reduce serum VEGF and AFP levels, improve disease control rate, and prolong progression-free survival time in the treatment of advanced liver cancer with controllable safety.

关 键 词：经肝动脉化疗栓塞 程序性死亡受体1抑制剂 晚期肝癌 血管内皮生长因子 甲胎蛋白 

分 类 号：R735.7[医药卫生—肿瘤]