肝胆胰外科杂志2024，Vol.36Issue(4)：193-197,204,6.DOI:10.11952/j.issn.1007-1954.2024.04.001
PD-1抑制剂预防肝细胞癌消融术后复发的临床研究
Efficacy of PD-1 inhibitors in preventing recurrence of hepatocellular carcinoma after local ablation
摘要
Abstract
Objective To explore the efficacy and safety of programmed cell death protein-1(PD-1)inhibitors as adjunctive therapy for recurrence of hepatocellular carcinoma(HCC)after local ablation.Methods A total of 63 HCC patients who received sequential therapy of transcatheter arterial embolization(TAE)combined with local ablation(microwave ablation or radiofrequency ablation),and achieved complete ablation,in Beijing Youan Hospital from Jan.2021 to Mar.2023,were prospectively selected.According to the patient's wishes,the 63 patients were assigned to either the experimental group(n=31)or the control group(n=32).Patients in the experimental group received adjuvant treatment of PD-1 inhibitor(Camrelizumab,200 mg,once every 3 weeks)after local ablation,while patients in the control group received no adjuvant treatment.The accumulated recurrence rate curve was performed by Kaplan-Meier method,and the difference of survival rates between the two groups was compared by Log-rank test.Cox regression analysis was used for univariate and multivariate analysis of risk factors of relapse free survival(RFS)in patients with HCC after local ablation.Results After a median follow-up of 8 months,the recurrence rate in the experimental group was significantly lower than that in the control group(41.94%vs 68.75%,χ2=4.59,P=0.03).The incidence rate of immune related adverse events in the experimental group was 92.59%for grade 1-2,and 7.41%for grade≥3.Tumor diameter(HR=0.49,95%CI 0.25-0.98,P<0.05)and anti PD-1 adjuvant therapy(HR=0.41,95%CI 0.20-0.85,P<0.05)were independent influencing factors for the RFS of HCC patients after local ablation(P<0.05).Conclusion This short-term study shows that djuvant therapy of PD-1 inhibitors is safe and effective in preventing recurrence of HCC after local ablation.关键词
肝细胞癌/程序性细胞死亡受体-1抑制剂/微波消融/射频消融/肝癌复发/无复发生存期Key words
hepatocellular carcinoma/programmed cell death protein-1 inhibitors/microwave ablation/radiofrequency ablation/recurrence of hepatocellular carcinoma/relapse free survival分类
医药卫生引用本文复制引用
张洪海,袁春旺,生守鹏,张永宏,孙玉..PD-1抑制剂预防肝细胞癌消融术后复发的临床研究[J].肝胆胰外科杂志,2024,36(4):193-197,204,6.基金项目
北京市属医院科研培育计划(PX2022067). （PX2022067）
