临床肝胆病杂志2024，Vol.40Issue(3)：550-555,6.DOI:10.12449/JCH240318
经肝动脉化疗栓塞术联合靶向及免疫药物治疗中国肝癌分期Ⅱb/Ⅲa期肝细胞癌患者的有效性及安全性分析
Efficacy and safety of transcatheter arterial chemoembolization combined with targeted therapy and immunotherapy in treatment of patients with stage Ⅱb/Ⅲa hepatocellular carcinoma based on China Liver Cancer Staging
摘要
Abstract
Objective To evaluate the efficacy and safety of first-line transcatheter arterial chemoembolization(TACE)combined with targeted therapy and immunotherapy in the treatment of patients with stage Ⅱb/Ⅲa hepatocellular carcinoma(HCC)based on China Liver Cancer Staging(CNLC).Methods A total of 198 patients who received first-line TACE combined with targeted therapy and immunotherapy or received TACE alone from January 2015 to December 2022 in the First Affiliated Hospital of Soochow University were enrolled in this study,and after propensity score matching,there were 50 patients in combination group and 50 patients in TACE group.The Kaplan-Meier method was used to calculate median overall survival(mOS)and median progression-free survival(mPFS).Modified Response Evaluation Criteria in Solid Tumors was used to evaluate objective response rate(ORR)and disease control rate(DCR),and Common Terminology Criteria for Adverse Events v5.0 was used to evaluate adverse events.The chi-square test was used for comparison of categorical data between two groups;the t-test was used for comparison of normally distributed continuous data between two groups,and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups.The Kaplan-Meier method was used to estimate survival time and calculate 95%confidence interval(CI),and the Log-rank test was used for comparison of mOS and mPFS between two groups.Results The combination group had an mOS of 30.1 months(95%CI:21.9—38.3),and the TACE group had an mOS of 14.5 months(95%CI:11.0—18.0),with a significant difference between the two groups(χ2=17.8,P<0.001);the combination group had an mPFS of 10.3 months(95%CI:8.8—11.8),and the TACE group had an mPFS of 7.1 months(95%CI:5.8—8.4),with a significant difference between the two groups(χ2=10.4,P<0.001).There were significant differences between the combination group and the TACE group in ORR(84%vs 58%,P<0.05)and DCR(94%vs 80%,P<0.05).There was no significant difference between the combination group and the TACE group in the incidence rate of adverse events(24%vs 16%,P=0.317),and no adverse event-related deaths were observed in either group.Conclusion Compared with TACE alone,TACE combined with targeted therapy and immunotherapy has a better efficacy in the treatment of patients with CNLC stage Ⅱb/Ⅲa HCC,without increasing the incidence rate of severe adverse events.关键词
癌,肝细胞/化学栓塞,治疗性/系统治疗/治疗结果Key words
Carcinoma,Hepatocellular/Chemoembolization,Therapeutic/Systematic Therapy/Treatment Outcome引用本文复制引用
胡泽鑫,李佳清,李婉慈,仲斌演,张帅,沈健,朱晓黎..经肝动脉化疗栓塞术联合靶向及免疫药物治疗中国肝癌分期Ⅱb/Ⅲa期肝细胞癌患者的有效性及安全性分析[J].临床肝胆病杂志,2024,40(3):550-555,6.基金项目
江苏省社会发展项目(BE2021648) Social Development Program of Jiangsu Province(BE2021648) （BE2021648）
