信迪利单抗联合贝伐珠单抗治疗不可切除肝细胞肝癌患者效果及其血清VEGF、MMP-9水平变化  

Curative Effect of Sintilimab Combined with Bevacizumab and Changes of Serum VEGF and MMP-9 in Patients with Unresectable Hepatocellular Carcinoma

作　　者：董伯升[1] 徐克友[1] 张静[1] 张淼 DONG Bosheng;XU Keyou;ZHANG Jing;ZHANG Miao(Department of Oncology,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]周口市中心医院肿瘤内科,河南周口466000

出　　处：《河南医学研究》2024年第3期524-528,共5页Henan Medical Research

摘　　要：目的 探讨信迪利单抗联合贝伐珠单抗治疗不可切除肝细胞肝癌患者效果及其血清血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)水平变化。方法 选取2021年1月至2022年12月在周口市中心医院确诊的80例不可切除肝细胞肝癌患者,根据患者治疗方式将患者分为单抗联合组和对照组。对照组患者接受口服甲苯磺酸索拉非尼治疗,纳入36例;单抗联合组接受信迪利单抗联合贝伐珠单抗治疗,纳入44例。记录两组患者治疗4个周期后的病情控制率和客观缓解率,比较治疗前、治疗2个周期后、治疗4个周期后血清VEGF和MMP-9水平变化,比较治疗毒副作用发生情况。随访6~30个月,绘制生存曲线,比较两组患者中位总生存时间(OS)和中位无进展生存时间(PFS)。结果 单抗联合组患者病情控制率和客观缓解率分别为77.27%和25.00%,对照组分别为44.44%和5.56%,差异有统计学意义(P<0.05)。治疗后,单抗联合组患者血清VEGF和MMP-9水平均随着时间降低,且低于对照组,差异有统计学意义(P<0.05)。单抗联合组患者甲状腺功能减退发生率为18.18%,对照组为2.78%,差异有统计学意义(P<0.05);单抗联合组患者脱发和手足综合征发生率均为0,对照组分别为22.22%和27.78%,差异均有统计学意义(P<0.05)。所有患者中位随访时间为18个月,单抗联合组患者中位OS和中位PFS分别为16.9个月和4.8个月,对照组患者中位OS和中位PFS分别为10.5个月和3个月,两组比较差异有统计学意义(P<0.05)。结论 信迪利单抗联合贝伐珠单抗治疗可以较好地控制不可切除肝细胞肝癌患者病情发展,显著降低血清肿瘤相关因子水平,提高生存率,且安全性较好。Objective To explore the curative effect of sintilimab combined with bevacizumab and changes of serum vascular endothelial growth factor(VEGF)and matrix metalloproteinase-9(MMP-9)in patients with unresectable hepatocellular carcinoma(HCC).Methods A total of 80 patients with unresectable HCC confirmed in Zhoukou Central Hospital were enrolled between January 2021 and December 2022.According to treatment methods,they were divided into control group and combination group.Control group received oral sorafenib toluene sulfonate treatment,including 36 cases.The combined group received sindilizumab combined with bevacizumab,and 44 cases were included.The disease control rates and objective remission rates in the two groups were recorded after 4 cycles of treatment.The changes of serum VEGF and MMP-9 before treatment and after 2 and after 4 cycles of treatment,and the occurrence of side effects during treatment were compared between the two groups.After 6-30 months of follow-up,survival curves were drawn to compare median overall survival(OS)and median progression-free survival(PFS)between the two groups.Results There were significant differences in disease control rate and objective remission rate between combination group and control group(77.27%vs 44.44%,25.00%vs 5.56%,P<0.05).After treatment,levels of serum VEGF and MMP-9 were decreased in combination group,and which were lower than those in control group(P<0.05).The differences in incidence of hypothyroidism between combination group and control group were statistically significant(18.18%vs 2.78%,P<0.05).The difference in incidence of alopecia and hand foot syndrome between combination group and control group was statistically significant(0 vs 22.22%,0 vs 27.78%,P<0.05).The median follow-up time for all patients was 18 months.The median OS and PFS in combination group were 16.9 months and 4.8 months,which in control group were 10.5 months and 3 months,and the difference between the two groups was statistically significant(P<0.05).Conclusion Sintilimab combined with

关 键 词：信迪利单抗 贝伐珠单抗 肝癌 血管内皮生长因子 基质金属蛋白酶-9 

分 类 号：R735.7[医药卫生—肿瘤]