仑伐替尼联合肝动脉插管化疗栓塞术治疗不可切除晚期肝癌的疗效及生存率影响因素分析  

Evaluation of curative effect and analysis of factors influencing survival rate of unresectable advanced liver cancer treated with lenvatinib combined with TACE

作　　者：宋然 郑雅各 Song Ran;Zheng Yage(Department of Oncology,Xuzhou Hospital of Traditional Chinese Medicine,Xuzhou 221000,China)

机构地区：[1]徐州市中医院肿瘤科,江苏省221000

出　　处：《中华消化病与影像杂志(电子版)》2025年第2期120-124,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的评价不可切除晚期肝癌运用仑伐替尼联合肝动脉插管化疗栓塞术(TACE)治疗的疗效,并分析影响患者生存率的危险因素。方法回顾性分析徐州市中医院肿瘤科、介入科2023年1月至2023年7月接诊的160例不可切除晚期肝癌患者的临床资料。所有患者均接受仑伐替尼联合TACE治疗。记录所有患者治疗8周的临床疗效、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原199(CA199)的变化,并记录12个月生存率情况及无进展生存期(PFS),采用多因素Logistic回归分析,分析影响患者生存率的危险因素。结果160例患者中,客观缓解率(ORR)为36.25%,疾病控制率为73.13%;患者治疗后ALT、AST、TBIL、AFP、CEA、CA199均低于治疗前,差异均有统计学意义(P<0.05);随访结果分析,患者中死亡54例、存活106例,患者12个月生存率为63.75%,PFS为7.55个月。多因素Logistic回归分析显示,巴塞罗那(BCLC)分期(OR 5.801,95%CI 2.345~14.347)、门静脉癌栓(OR 6.328,95%CI 2.509~15.961)、外周血中性粒细胞/淋巴细胞比值(NLR)(OR 4.978,95%CI 2.350~10.545)、系统免疫炎症指数(SII)(OR 4.773,95%CI 2.275~10.013)均是影响患者生存率的危险因素(P<0.05)。结论仑伐替尼联合TACE治疗可改善不可切除晚期肝癌患者的肝功能,BCLC分期、门静脉癌栓、NLR、SII是影响患者生存率的危险因素,临床上应予以重视。Objective To evaluate the efficacy of lenvatinib combined with transcatheter arterial chemoembolization(TACE)in the treatment of unresectable advanced liver cancer,and to analyze the risk factors affecting the survival rate of patients.Methods The clinical data of 160 patients with unresectable advanced liver cancer admitted to the Department of Oncology and Department of Intervention of our hospital from January 2023 to July 2023 were retrospectively analyzed.All patients received lenvatinib combined with TACE.The clinical efficacy of all patients after 8 weeks of treatment and the changes of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)were recorded,and the 12-month survival rate and progression-free survival(PFS)were recorded,the multivariate Logistic regression analysis was used to analyze the risk factors affecting the survival rate of patients.Results Among the 160 patients,the objective response rate(ORR)was 36.25%and the disease control rate(DCR)was 73.13%.ALT,AST,TBIL,AFP,CEA and CA199 after treatment were all lower than before treatment,with statistically significant differences(P<0.05).The follow-up analysis showed that 54 patients died and 106 survived,the 12-month survival rate was 63.75%,and PFS was 7.55 months.Multivariate Logistic regression analysis showed that Barcelona(BCLC)stage(OR:5.801,95%CI:2.345-14.347),portal vein cancer embolus(OR:6.328,95%CI:2.509-15.961),peripheral blood neutrophil/lymphocyte ratio(NLR)(OR:4.978,95%CI:2.350-10.545)and systemic immunoinflammatory Index(SII)(OR:4.773,95%CI:2.275-10.013)were the risk factors affecting the prognosis of patients(P<0.05).Conclusion Lenvatinib combined with TACE improves liver function in patients with unresectable advanced liver cancer,BCLC stage,portal vein cancer embolus,NLR and SII are risk factors affecting the survival rate of patients,and should be paid attention to clinically.

关 键 词：原发性肝癌 靶向治疗 肝动脉插管化疗栓塞术 仑伐替尼 预后 危险因素 

分 类 号：R735.7[医药卫生—肿瘤]