TACE、免疫治疗联合仑伐替尼与联合贝伐珠单抗治疗晚期肝癌的疗效对比  

Efficacy comparison of TACE,immunotherapy combined with lenvatinib and bevacizumab in the treatment of advanced liver cancer

作　　者：吴林 刘晓晨[1] 段剑锋 段昌虎[1] 杨帆[1] WU Lin;LIU Xiaochen;DUAN Jianfeng;DUAN Changhu;YANG Fan(Department of Hepatobiliary Sugery,Xi'an Jiaotong University School of Medicine Affiliated Hanzhong 3201 Hospital,Shaanxi Hanzhong 723000,China)

机构地区：[1]西安交通大学医学院附属汉中三二〇一医院肝胆外科,陕西汉中723000

出　　处：《现代肿瘤医学》2024年第17期3264-3269,共6页Journal of Modern Oncology

摘　　要：目的:探讨TACE、PD-1单抗联合贝伐珠单抗与TACE、PD-1单抗联合仑伐替尼治疗晚期肝癌疗效差异及成功转化手术情况。方法:选取全身状况不可一期手术切除的晚期肝癌患者52例,随机分为对照组和观察组,对照组27例,观察组25例。对照组采用TACE、PD-1单抗联合仑伐替尼,观察组采用TACE、PD-1单抗联合贝伐珠单抗。比较两组治疗效果、肿瘤标志物变化情况、不良反应及手术转化情况。结果:治疗3周期后两组各项指标差异无统计学意义(P>0.05)。治疗6周期后观察组AFP下降水平、肿瘤客观缓解率(ORR)、疾病控制率(DCR)均优于对照组(P<0.05)。且4例经转化后可手术的患者均在观察组。两组不良反应发生例数均较少,差异无统计学意义,后续继续随访对比。结论:观察组较对照组治疗6周期后AFP下降水平、肿瘤客观缓解率(ORR)、疾病控制率(DCR)均优于对照组,随着样本量的增加可能会证实观察组相比对照组手术转化成功率更高,起效更快等结果。Objective:To investigate the difference in efficacy of TACE,sintilimab combined with bevacizumab and TACE,sintilimab combined with lenvatinib in the treatment of advanced liver cancer and the successful conversion surgery.Me thods:Fifty-two patients with advanced liver cancer who could not be resected by primary surgery were randomly divided into control group( n = 27) and observation group( n = 25).The control group received TACE,sintilimab combined with lenvatinib,while the observation group received TACE,sintilimab combined with bevacizumab.The treatment effect,tumor marker changes,adverse reactions and surgical transformation were compared between the two groups.Re sults:After 3 cycles of treatment,there was no significant difference in the indexes between the two groups( P > 0.05).After 6 cycles of treatment,the decreased level of AFP,objective response rate( ORR) and disease control rate( DCR) of the observation group were better than those of the control group( P < 0.05).And 4 patients who were operable after transformation were in the observation group.However,due to the small number of adverse reactions between the two groups,the difference is not significant.Conclusion:After 6 cycles of treatment,the decreased levels of AFP,ORR and DCR of the observation group are better than that of the control group.With the increase of the sample size,it may be confirmed that the success rate of surgical transformation in the observation group is higher,and the effect of the observation group is faster than that of the control group.

关 键 词：晚期肝癌 PD-1单抗 贝伐珠单抗 仑伐替尼 甲胎蛋白 

分 类 号：R735.7[医药卫生—肿瘤]