三联治疗与两联治疗在中晚期肝细胞癌中的对比研究  

Comparative study of triple therapy and double therapy in intermediate or advanced stage hepatocellular carcinoma

作　　者：李刚[1] 易根发[1] 赵卫[1] 张晓东 孟雪柔 王俊超 LI Gang;YI Genfa;ZHAO Wei;ZHANG Xiaodong;MENG Xuerou;WANG Junchao(Department of Medical Imaging,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院医学影像科,云南昆明650032

出　　处：《实用放射学杂志》2024年第9期1503-1507,共5页Journal of Practical Radiology

基　　金：云南省放射与治疗临床医学研究中心基金项目(202102AA10067)。

摘　　要：目的 比较经动脉化疗栓塞(TACE)联合仑伐替尼及卡瑞利珠单抗(三联治疗)与TACE联合仑伐替尼(两联治疗)在中晚期肝细胞癌(HCC)治疗中的有效性与安全性差异.方法 回顾性收集145例诊断HCC接受三联治疗或两联治疗患者的临床资料,比较2组患者在客观缓解率(ORR)、疾病控制率(DCR)、中位无进展生存期(mPFS)、中位总生存期(mOS)和不良事件等方面的差异.结果 三联治疗组1、3、6个月的ORR及DCR均高于两联治疗组,且3、6个月的ORR、DCR差异有统计学意义.三联治疗组的mPFS及mOS也均高于两联治疗组,差异有统计学意义.Cox比例风险模型结果显示治疗方式、肿瘤最大径、甲胎蛋白(AFP)是无进展生存期(PFS)、总生存期(OS)的独立危险因素.另外,巴塞罗那临床肝癌(BCLC)分期是OS的独立危险因素.在不良事件上,三联治疗组反应性皮肤毛细血管增生症(RCCEP)及甲状腺功能减退发生率高于两联治疗组,且差异有统计学意义.结论 相比于两联治疗,三联治疗可以明显提升中晚期HCC的疗效,延长患者的PFS、OS,且安全性可控.Objective To compare the differences in efficacy and safety between transarterial chemoembolization(TACE)com-bined with lenvatinib and camrelizumab(triple therapy)and TACE combined with lenvatinib(double therapy)in intermediate or advanced stage hepatocellular carcinoma(HCC).Methods The clinical data of 145 patients who were diagnosed with HCC and received triple therapy or double therapy were retrospectively collected.The differences of objective response rate(ORR),disease control rate(DCR),median progression-free survival(mPFS),median overall survival(mOS),and adverse events were compared between the two groups.Results The ORR and DCR in 1,3 and 6 months of the triple therapy group were higher than those of the double therapy group,and the differences were statistically significant in 3 and 6 months.The mPFS and mOS of the triple therapy group were higher than those of the double therapy group,and the differences were statistically significant.The Cox proportional hazards model results showed that the therapy methods,maximum tumor diameter and alpha-fetoprotein(AFP)were independent risk factors of progres-sion-free survival(PFS)and overall survival(OS).Besides,Barcelona Clinic Liver Cancer(BCLC)staging was independent risk fac-tor of OS.In terms of adverse events,the incidence of reactive cutaneous capillary endothelial proliferation(RCCEP)and hypothy-roidism in the triple therapy group were higher than those in the double therapy group,and the differences were statistically signifi-cant.Conclusion n Compared with double therapy,triple therapy can significantly improve the efficacy of intermediate or advanced stage HCC,prolong patients'PFS and OS,and its safety can be well controlled.

关 键 词：肝细胞癌 经动脉化疗栓塞 仑伐替尼 卡瑞利珠单抗 有效性 安全性 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]