卡瑞利珠单抗联合甲磺酸阿帕替尼、替吉奥治疗中晚期原发性肝癌的临床观察  

Clinical Observation on the Treatment of Middle and Late Stage Primary Liver Cancer with Karelizumab Combined with Apatinib Mesylate and Tegiol

作　　者：李苗 朱映霞[1] 段相会 LI Miao;ZHU Yingxia;DUAN Xianghui(The Third District of Oncology,the First People's Hospital of Qinzhou,Qinzhou 535099,China;Department of Hematology,Qinzhou First People's Hospital,Qinzhou 535099,China)

机构地区：[1]钦州市第一人民医院肿瘤内科三区,广西钦州535099 [2]钦州市第一人民医院血液科,广西钦州535099

出　　处：《中国医药指南》2023年第22期22-25,共4页Guide of China Medicine

基　　金：卡瑞利珠单抗联合甲磺酸阿帕替尼、替吉奥治疗中晚期原发性肝癌的临床观察,广西壮族自治区卫生健康委员会自筹经费科研课题,合同编号:Z20210708。

摘　　要：目的 卡瑞利珠单抗联合甲磺酸阿帕替尼、替吉奥治疗中晚期原发性肝癌的临床观察分析。方法 研究对象为26例在钦州市第一人民医院接受治疗的中晚期原发性肝癌患者,均于2020年6月至2022年1月入住我院,均接受卡瑞利珠单抗联合甲磺酸阿帕替尼、替吉奥治疗。分别采用irRECIST1.1与NCI-CTCAE4.0标准评价近期疗效和不良反应,对比治疗前后肝功能、肾功能水平的波动情况。并对患者进行为期1年的随访,记录其无进展生存期以及总生存期。结果 治疗后,26例患者的疾病控制率为96.15%;26例患者发生1、2级程度不良反应的前3种分别为丙氨酸转氨酶升高(76.92%)、腹泻(53.85%)、手足综合征(53.85%);发生3级程度不良反应的分别为肝脓肿(3.85%)、免疫性肺炎(3.85%)、脱发(3.85%)、腹泻(15.38%)、手足综合征(3.85%);26例患者治疗3 d后,26例患者的TBIL、ALT、AST水平显著高于治疗前(P <0.05);治疗1周后,26例患者的TBIL、ALT、AST水平显著低于治疗3 d后(P <0.05),与治疗前相比无差异(P> 0.05);与治疗前相比,26例患者治疗3 d后、1周后的Scr、PRO、BUN水平均无明显差异(P> 0.05);对患者进行为期1年的随访,26例患者的中位无进展生存期为7个月,中位总生存期为10个月。结论 中晚期原发性肝癌患者行卡瑞利珠单抗联合甲磺酸阿帕替尼、替吉奥治疗取得了显著治疗效果,患者具有相对较高的无进展生存期以及总生存期,且治疗安全性较佳。Objective To observe and analyze the clinical efficacy of combination therapy with calilizumab,apatinib mesylate,and tigio in the treatment of advanced primary liver cancer.Methods The study subjects were 26 patients with advanced primary liver cancer who received treatment at the First People's Hospital of Qinzhou City,all of whom were admitted to our hospital from June 2020 to January 2023.They all received treatment with calilizumab combined with apatinib mesylate and telgilol.The recent efficacy and adverse reactions were evaluated using irRECIST1.1 and NCI-CTCAE4.0 standards respectively,and the fluctuations in inflammatory factor levels,liver function,and kidney function levels before and after treatment were compared.And a one-year follow-up was conducted on the patient to record their progression free survival and overall survival.Results After treatment,the disease control rate of 26 patients was 96.15%;the first three kinds of adverse reactions of grade 1 and grade 2 in 26 patients were elevated alanine transaminase(76.92%),diarrhea(53.85%)and hand foot syndrome(53.85%).The three levels of adverse reactions were liver abscess(3.85%),immune pneumonia(3.85%),alopecia(3.85%),diarrhea(15.38%),and hand foot syndrome(3.85%).After three days of treatment,the levels of TBIL,ALT,and AST in 26 patients were significantly higher than before treatment(P<0.05).After one week of treatment,the levels of TBIL,ALT,and AST in 26 patients were significantly lower than those after three days of treatment(P<0.05),compared to before treatment(P>0.05).Compared with before treatment,the levels of Scr,PRO,and BUN in 26 patients showed no significant difference after three days and one week of treatment(P>0.05).The patients were followed up for one year,and the median progression free survival of 26 patients was 7 months,with a median overall survival of 10 months.Conclusion Carolizumab combined with apatinib mesylate and tigio therapy has achieved significant therapeutic effects in patients with advanced primary liver cancer.Th

关 键 词：卡瑞利珠单抗 甲磺酸阿帕替尼 替吉奥 中晚期原发性肝癌 

分 类 号：R735.7[医药卫生—肿瘤]