肝动脉灌注化疗栓塞术联合肝细胞靶向免疫治疗对原发性巨块型肝癌的治疗效果  

Therapeutic effect of transarterial chemoembolization combined with liver cell-targeted immunotherapy on primary massive hepatocellular carcinomas

作　　者：王爱华 林丛 崔豹 刘晶磊 李亮 梁志会 WANG Aihua;LIN Cong;CUI Bao(The Seventh Medical Center,Chinese PLA General Hospital,Beijing 100700,China;不详)

机构地区：[1]中国人民解放军总医院第七医学中心,北京市100700 [2]中国人民解放军联勤保障部队第九八〇医院

出　　处：《河北医药》2024年第23期3546-3550,共5页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20231318);石家庄市科技计划项目(编号:221460633)。

摘　　要：目的 分析肝动脉灌注化疗栓塞术(TACE)联合肝细胞靶向免疫对原发性巨块型肝癌的临床治疗效果。方法 选取联勤保障部队第九八〇医院2020年12月至2022年12月收治的300例原发性巨块型肝癌患者为研究对象,随机分成研究组196例和对照组104例,其中研究组患者给予TACE联合靶向免疫治疗,对照组患者给予TACE联合靶向药物治疗。治疗结束后比较2组患者肿瘤直径、疾病缓解情况、肿瘤标志物水平、不良事件发生率及预后情况等。结果 治疗前2组肿瘤直径无明显差异,治疗1个月后研究组肿瘤直径明显小于对照组(P<0.05);研究组客观缓解率(ORR)54.08%、疾病控制率(DCR)94.89%,对照组ORR 26.92%、DCR 80.77%,2组比较差异均有统计学意义(P<0.05);研究组和对照组患者6个月生存率为81.12%和49.04%,12个月生存率为62.76%和36.54%,18个月生存率为44.39%和20.19%,差异均有统计学意义(P均<0.05)。治疗后2组发生肝功能异常、肾功能异常、胃肠道反应等不良事件总发生率比较差异无统计学意义(P>0.05)。结论 TACE联合肝细胞靶向免疫治疗原发性巨块型肝癌,能够缩小肿瘤直径、缓解病情、降低肿瘤标志物水平和改善预后,且不良事件发生率未显著增加,值得临床推广应用。Objective To analyze the clinical efficacy of transarterial chemoembolization(TACE)combined with liver cell-targeted immunity on primary massive hepatocellular carcinomas.Methods A total of 300 patients with primary giant hepatocellular carcinomas admitted to 980th Hospital of PLA from December 2020 to December 2022 were selected as the study subjects.They were randomly assigned into the study group(TACE combined with liver cell-targeted immunotherapy,n=196)and the control group(TACE combined with targeted medication,n=104).The tumor diameter,disease response,tumor marker levels,incidence of adverse events,and prognosis were compared between two groups after treatment.Results There was no significant difference in tumor diameter between groups before treatment.After 1 month of treatment,the average tumor diameter of the study group was significantly smaller than that of the control group(6.3cm vs 8.8cm,P<0.05).The objective response rate(ORR,54.08%vs 26.92%)and disease control rate(DCR,94.89%vs 80.77%)in the study group were significantly higher than those the control group(P<0.05).The 6-month(81.12%vs 49.04%),12-month(62.76%vs 36.54%)and 18-month survival rates(44.39%vs 20.19%)of the study group were significantly higher than those of the control group(all P<0.05).There was no significant difference in the total incidence of adverse events,such as abnormal liver function,abnormal renal function,and gastrointestinal reactions between groups after treatment(P>0.05).Conclusion TACE combined with liver cell-targeted immunotherapy can reduce tumor diameter,alleviate symptoms,lower tumor marker levels,and improve prognosis of primary massive hepatocellular carcinomas,without significantly increasing the incidence of adverse events.It is worthy of clinical promotion and application.

关 键 词：原发性巨块型肝癌 肝动脉灌注化疗栓塞术 靶向药物 免疫检查点抑制剂 

分 类 号：R735.7[医药卫生—肿瘤]