仑伐替尼及PD-1抑制剂联合经导管动脉栓塞化疗治疗不可切除肝细胞癌临床观察  

Clinical Observation of Lenvatinib,PD-1 Inhibitor Combined with Transcatheter Arterial Chemoembolization in the Treatment of Unresectable Hepatocellular Carcinoma

作　　者：张峰 董燕兵 陈方园 牛猛 刘子洋 谈燚[2] ZHANG Feng;DONG Yanbing;CHEN Fangyuan;NIU Meng;LIU Ziyang;TAN Yi(People's Hospital of Funan County,Fuyang,Anhui,China 236300;The First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui,China 233030)

机构地区：[1]安徽省阜阳市阜南县人民医院,安徽阜阳236300 [2]蚌埠医学院第一附属医院,安徽蚌埠233030

出　　处：《中国药业》2024年第14期102-105,共4页China Pharmaceuticals

基　　金：安徽省教育厅重点项目[2022AH051416]。

摘　　要：目的 探讨仑伐替尼、程序性死亡受体-1(PD-1)抑制剂联合经导管动脉栓塞化疗(TACE)治疗不可切除肝细胞癌(uHCC)的临床疗效。方法 选取安徽省阜阳市阜南县人民医院2020年7月至2023年7月收治的uHCC患者106例,按治疗方案的不同分为对照组(32例)、药物组(34例)和联合组(40例),分别予TACE、TACE+PD-1抑制剂、TACE+PD-1抑制剂+仑伐替尼方案治疗,其中PD-1抑制剂为信迪利单抗注射液、替雷利珠单抗注射液、注射用卡瑞利珠单抗中三选一。3组治疗周期均为6周。结果 联合组疾病控制率为90.00%,显著高于对照组的65.63%和药物组的70.59%(P <0.05)。联合组患者治疗后的丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素、甲胎蛋白、癌胚抗原、α-L-岩藻糖苷酶、糖类抗原199水平及生活质量核心量表评分均显著低于对照组及药物组(P <0.05)。3组不良反应发生率无显著差异(P> 0.05)。结论 仑伐替尼、PD-1抑制剂联合TACE治疗uHCC,可有效改善患者的肝功能,降低血清肿瘤标志物水平,提高患者预后的生活质量。Objective To investigate the clinical efficacy of lenvatinib,programmed death-1(PD-1)inhibitor combined with transcatheter arterial chemoembolization(TACE)in the treatment of unresectable hepatocellular carcinoma(uHCC).Methods A total of 106 patients with uHCC admitted to the People′s Hospital of Funan County from July 2020 to July 2023 were selected and divided into the control group(32 cases),the drug group(34 cases)and the combined group(40 cases)based on the different treatment regimens.The patients in the three groups were given TACE,TACE+PD-1 inhibitor,TACE+PD-1 inhibitor+lenvatinib respectively,in which the PD-1 inhibitor was one of Sintilimab Injection,Tislelizumab Injection and Camrelizumab for Injection.All three groups were treated for six weeks.Results The disease control rate(DCR)in the combined group was 90.00%,which was significantly higher than 65.63%in the control group and 70.59%in the drug group(P<0.05).After treatment,the alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBiL),α-fetoprotein(AFP),carcinoembryonic antigen(CEA),α-L-fucosidase(AFU),carbohydrate antigen 199(CA199)levels and Quality of Life Questionnaire-Core 30(QLQ-C30)score in the combined group were significantly lower than those in the control group and drug group(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion Lenvatinib and PD-1 inhibitor combined with TACE can effectively improve liver function,decrease serum tumor biomarker levels,and improve the quality of life in patients with uHCC.

关 键 词：仑伐替尼 程序性死亡受体-1 经导管动脉栓塞化疗 不可切除肝细胞癌 肝功能 肿瘤标志物 生活质量 

分 类 号：R969.4[医药卫生—药理学] R734.2[医药卫生—药学]