微创消融联合TACE+派安普利单抗及安罗替尼治疗中晚期肝细胞肝癌的有效性、安全性及生存随访  

Efficacy,safety,and survival follow-up of minimally invasive ablation combined with TACE plus pembrolizumab and anlotinib in treatment of advanced hepatocellular carcinoma

作　　者：兑伟华 乔炳礼[1] Dui Weihua;Qiao Bingli(Department of Digestive Oncology,Zhengzhou Third People's Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市第三人民医院消化肿瘤内科,河南郑州450000

出　　处：《齐齐哈尔医学院学报》2025年第5期449-453,共5页Journal of Qiqihar Medical University

基　　金：河南省医学科技攻关项目(LHGJ20191024)。

摘　　要：目的探讨微创消融联合动脉灌注化疗栓塞治疗(Transcatheter arterial chemoembolization,TACE)+派安普利单抗及安罗替尼治疗中晚期肝细胞肝癌的有效性、安全性及生存情况。方法选择2020年1月-2023年1月本院收治的66例中晚期肝细胞肝癌患者作为研究对象,随机数表法分为对照组和观察组2组,每组各33例。对照组采用微创消融联合TACE治疗,观察组在对照组基础上联合派安普利单抗及安罗替尼治疗。对比2组患者治疗前后肿瘤最大径及体积、临床有效率和疾病控制率、肿瘤标志物水平、不良反应情况发生率。记录随访半年、1年、1.5年时两组患者的生存率。结果治疗后,观察组肝肿瘤最大径为(2.75±0.69)cm、体积为(8.49±1.32)cm^(3),均明显低于对照组(P<0.05)。观察组临床有效率为69.70%、疾病控制率为87.88%,均明显高于对照组(P<0.05)。观察组癌胚抗原为(8.32±1.32)ng/ml、糖类抗原199为(33.86±7.46)U/ml、糖类抗原125为(23.43±6.81)U/ml、甲胎蛋白为(313.28±78.55)ng/ml,均明显低于对照组(P<0.05)。观察组术后18个月生存率为84.85%,显著高于对照组的63.64%(P<0.05)。结论微创消融联合TACE+派安普利单抗及安罗替尼治疗中晚期肝细胞肝癌,可有效促进肿瘤消退,提升治疗效果,减少病情进展风险,延长患者生存期,且安全性较高。Objective To explore the efficacy,safety,and survival status of minimally invasive ablation combined with transcatheter arterial chemoembolization(TACE)plus pembrolizumab and anlotinib in the treatment of advanced hepatocellular carcinoma.Methods A total of 66 patients with advanced hepatocellular carcinoma admitted to our hospital from January 2020 to January 2023 were selected as study subjects and randomly divided into two groups,with 33 cases in each group.The control group was treated with minimally invasive ablation combined with TACE,while the observation group received pembrolizumab and anlotinib in addition to the treatment of the control group.The maximum diameter and volume of the tumor,clinical efficacy and disease control rate,tumor marker levels,and incidence of adverse reactions were compared between the two groups before and after treatment.The survival rates of the two groups at six months,one year,and one and a half years of follow-up were recorded.Results After treatment,the maximum diameter of liver tumor in the observation group was(2.75±0.69)cm and the volume was(8.49±1.32)cm^(3),both significantly lower than those in the control group(P<0.05).The clinical efficacy rate and disease control rate in the observation group were 69.70%and 87.88%,respectively,both significantly higher than those in the control group(P<0.05).The carcinoembryonic antigen level in the observation group was(8.32±1.32)ng/ml,carbohydrate antigen 199 was(33.86±7.46)U/ml,carbohydrate antigen 125 was(23.43±6.81)U/ml,and alpha-fetoprotein was(313.28±78.55)ng/ml,significantly lower than those in the control group(P<0.05).The survival rate of the observation group at 18 months after surgery was 84.85%,significantly higher than 63.64%in the control group(P<0.05).Conclusions Minimally invasive ablation combined with TACE plus pembrolizumab and axitinib in the treatment of advanced hepatocellular carcinoma can effectively promote tumor regression,improve treatment effect,reduce the risk of disease progression,prolong patie

关 键 词：微创消融 TACE 派安普利单抗 安罗替尼 中晚期肝细胞肝癌 有效率 

分 类 号：R73[医药卫生—肿瘤]