联合仑伐替尼的HAIC与TACE治疗晚期肝癌的临床疗效和安全性  

Comparison of efficacy of hepatic artery infusion chemotherapy combined with lenvatinib and hepatic artery chemoembolization in treatment for advanced liver cancer

作　　者：高安军 韩宇琛 江斌 GAO Anjun;HAN Yuchen;JIANG Bin(Center of Hepatobiliary and Pancreatic Surgery,the First Clinical College of Medicine,Hubei University of Medicine(Shiyan Taihe Hospital),Shiyan,Hubei 442000,China;School of Public Health,Hubei University of Medicine,Shiyan,Hubei 442000,China)

机构地区：[1]湖北医药学院第一临床医学院(十堰市太和医院)肝胆胰外科诊疗中心,湖北十堰442000 [2]湖北医药学院公共卫生与健康学院,湖北十堰442000

出　　处：《中国医学工程》2025年第3期35-40,共6页China Medical Engineering

摘　　要：目的 评估联合仑伐替尼的肝动脉灌注化疗(HAIC)与肝动脉化疗栓塞(TACE)治疗晚期肝细胞癌(HCC)的临床疗效和安全性。方法 选择湖北医药学院第一临床医学院感染科于2021年9月至2022年9月接受治疗的43例HCC患者。根据治疗方案不同,将患者分为HAIC组(HACI联合仑伐替尼,n=23)和TACE组(TACE联合仑伐替尼,n=20)。根据修订版实体肿瘤的疗效评价标准(mRECIST)对肿瘤的疗效进行评估,比较两组患者在总生存期(OS)、无进展生存期(PFS)、客观缓解率(ORR)、疾病控制率(DCR)和不良事件方面的差异。结果 HAIC组接受介入治疗的次数为2~6次,平均为(3.95±1.62)次,高于TACE组的2~4次,平均为(2.90±1.25)次。与TACE组相比,HAIC组接受仑伐替尼治疗的频率更高[(4.40±2.28)次vs.(3.12±2.85)次]。HAIC组的中位总生存期更长[12.0个月(95%CI:8.6~15.4)vs. 7.0个月(95%CI:5.9~8.1);P=0.017],具有更好的中位无进展生存期[6.0个月(95%CI:4.1~7.9) vs. 4.0个月(95%CI:2.5~5.5);P=0.021]和更高的ORR (56.5%vs. 15.0%;P<0.05)。两组DCR比较差异无统计学意义(P=0.711)。两组患者均未发生3~4级不良事件,无治疗相关死亡,其他不良事件发生情况差异无统计学意义。结论 在联合仑伐替尼治疗下,与TACE组相比,HAIC组能够改善患者生存周期,并提高晚期肝细胞癌患者的ORR。【Objective】To evaluate the clinical efficacy and safety of hepatic arterial infusion chemotherapy(HAIC)combined with lenvatinib compared with hepatic arterial chemoembolization(TACE)in the treatment for advanced hepatocellular carcinoma(HCC).【Methods】A total of 43 HCC patients who were treated in the Infectious Diseases Department of the First Clinical College of Medicine,Hubei University of Medicine between September 2021 and September 2022 were selected.Patients were divided into HAIC group(HACI combined with lenvatinib,n=23)and TACE group(TACE combined with lenvatinib,n=20)according to the treatment regimen.The efficacy of the tumors was evaluated according to the modified Response Evaluation Criteria in Solid Tumors(mRECIST).Overall survival(OS),progression-free survival(PFS),objective response rate(ORR),disease control rate(DCR),and adverse events were compared between the two groups.【Results】The number of interventional therapy in HAIC group was 2 to 6 times,with an average of 3.95±1.62 times,which was higher than that in TACE group(2 to 4 times),with an average of 2.90±1.25 times.Compared with the TACE group,the HAIC group received lenvatinib more frequently(4.40±2.28 vs.3.12±2.85).Median overall survival(mOS)was longer in the HAIC group[12.0 months(95%CI:8.6 to 15.4)vs.7.0 months(95%CI:5.9 to 8.1);P=0.017],which had better median progression-free survival(mPFS)[6.0 months(95%CI:4.1 to 7.9)vs.4.0 months(95%CI:2.5 to 5.5);P=0.021]and a higher ORR(56.5%vs.15.0%;P<0.05).There was no significant difference in DCR between the two groups(P=0.711).There were no grade 3 to 4 adverse events,no treatment-related deaths,and no differences in the occurrence of other adverse events between the two groups.【Conclusion】Combined treatment with lenvatinib in the HAIC group improved patient survival and objective response rates in patients with advanced hepatocellular carcinoma compared with the TACE group.

关 键 词：肝脏肿瘤 肝动脉灌注化疗 肝动脉栓塞治疗 分子靶向治疗 

分 类 号：R453.9[医药卫生—治疗学]