经肝动脉介入化疗联合靶向治疗与免疫治疗在不可切除原发性肝细胞癌患者中的应用  

Application of transhepatic arterial interventional chemotherapy combined with targeted therapy and immunotherapy in patients with unresectable primary hepatocellular carcinoma

作　　者：姚红兵 吴杰松 熊艺晶 蒋建晖 徐军红 赵东康 陆才进 王雪尧 郭威 吴嘉兴 孔娟 李伟峰 YAO Hongbing;WU Jiesong;XIONG Yijing;JIANG Jianhui;XU Junhong;ZHAO Dongkang;LU Caijin;WANG Xueyao;GUO Wei;WU Jiaxing;KONG Juan;LI Weifeng(Department of Hepatobiliary and Pancreatic Surgery,the Second Affiliated Hospital of Guilin Medical University,Guilin 541000,Guangxi,China;Department of Interventional Radiology,the Second Affiliated Hospital of Guilin Medical University,Guilin 541000,Guangxi,China)

机构地区：[1]桂林医学院第二附属医院肝胆胰外科,广西桂林541000 [2]桂林医学院第二附属医院放射介入科,广西桂林541000

出　　处：《癌症进展》2024年第12期1343-1348,共6页Oncology Progress

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2021011);广西壮族自治区医疗卫生重点培育学科建设项目(桂卫科教发[2021]8号)。

摘　　要：目的探讨经肝动脉介入化疗[包括经导管动脉栓塞化疗(TACE)和/或肝动脉灌注化疗(HAIC)]联合靶向治疗和免疫治疗在不可切除原发性肝细胞癌(HCC)患者中的应用效果。方法依据治疗方法的不同将50例HCC患者分为TACE和/或HAIC联合靶免治疗组(n=25,TACE和/或HAIC、靶向治疗和免疫治疗)和标准治疗组(n=25,TACE和/或HAIC治疗)。观察患者的客观缓解率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)、总生存期(OS)和安全性。结果在实体瘤疗效评价标准(RECIST)1.1版评价标准下,ORR为36%,DCR为76%。在改良版RECIST评价标准下,ORR为72%,DCR为76%。TACE和/或HAIC联合靶免治疗组患者总生存情况和无进展生存情况均优于标准治疗组患者,差异均有统计学意义(P﹤0.05)。不良反应中,3~4级不良反应为神经病变(占4%),其他多为1~2级可管理的不良反应。结论TACE和/或HAIC联合靶免治疗能够显著提高不可切除HCC患者的疗效,延长患者的生存时间,且具有安全性。Objective To investigate the application effect of transcatheter arterial interventional chemotherapy[in-cluding transcatheter arterial chemoembolization(TACE)and/or hepatic arterial infusion chemotherapy(HAIC)]com-bined with targeted therapy and immunotherapy in patients with unresectable primary hepatocellular carcinoma(HCC).Method According to different treatment methods,50 HCC patients were divided into TACE and/or HAIC combined with targeted immunotherapy group(n=25,TACE and/or HAIC,targeted therapy,and immunotherapy)and standard treat-ment group(n=25,TACE and/or HAIC treatment).Objective response rate(ORR),disease control rate(DCR),progres-sionfree survival(PFS),overall survival(OS)and safety were observed.Result According to response evaluation crite-ria in solid tumor(RECIST)1.1,the ORR was 36%and the DCR was 76%.According to modified RECIST evaluation criteria,the ORR was 72%and the DCR was 76%.The overall survival and progression-free survival of patients in TACE and/or HAIC combined targeted therapy and immunotherapy group were better than those in standard therapy group,the differences were statistically significant(P<0.05).Among the adverse reactions,grade 3-4 adverse reactions were neurop-athy(4%),and the others were mostly grade 1-2 manageable adverse reactions.Conclusion TACE and/or HAIC com-bined targeted therapy and immunotherapy can significantly improve the efficacy of unresectable HCC patients,prolong the survival time of patients,and have safety.

关 键 词：原发性肝细胞癌 经导管动脉栓塞化疗 肝动脉灌注化疗 靶向治疗 免疫治疗 安全性 

分 类 号：R735.7[医药卫生—肿瘤]