肝胆胰外科杂志2025，Vol.37Issue(3)：179-184,6.DOI:10.11952/j.issn.1007-1954.2025.03.007
TACE联合HAIC加靶免"四联"疗法对中晚期肝细胞癌的疗效分析
Efficacy of TACE combined with HAIC plus targeted-immune quadruple therapy for advanced hepatocellular carcinoma
摘要
Abstract
Objective To investigate the safety and clinical efficacy of"quadruple therapy",transcatheter arterial chemoembolization(TACE)combined with hepatic arterial infusion chemotherapy(HAIC),targeted drugs and PD-1 immunosuppressive for advanced hepatocellular carcinoma(HCC).Methods A total of 88 patients with advanced HCC,who admitted to the Second Affiliated Hospital of Bengbu Medical University between Apr.2022 and Nov.2023,were retrospectively selected for this study.Patients in the control group(n=34)received triple therapy,while patients in the observational group(n=54)received quadruple therapy.The objective response rate,disease control rate,success rate of conversion to surgical resection,median overall survival time(mOS),median progression-free survival time(mPFS),adverse events and complications,and postoperative anxiety were compared between the two groups.Results According to the mRECIST criteria,the objective response rate(19/54,35.19%)and disease control rate(33/54,61.11%)in the observational group were significantly higher than those in the control group(5/34,14.71%and 11/34,32.35%,respectively),the differences were statistically significant(χ2=4.412,P<0.05;χ2=6.902,P<0.05).The success rate of conversion to surgical resection in the observational group(17/54,31.48%)was also higher than that in the control group(3/34,8.82%),and the difference was statistically significant(χ2=6.099,P<0.05).The mOS of 17.4 months(95%CI 16.0 to 18.8)and mPFS of 14.6 months(95%CI 12.7 to 16.5)in the observational group were significantly longer than those in the control group[12.4 months(95%CI 10.4 to 14.4),9.3 months(95%CI 8.8 to 9.7)],and the differences were statistically significant(P<0.001).There was no significant difference in terms of complication incidence rate between the two groups after interventional therapy(P>0.05).The most common complication in both groups was the increase of γ-glutamyl transferase,followed by abdominal pain and nausea.The incidence of pain and anxiety in the observational group was higher than that in the control group,and the difference was statistically significant(χ2=11.74,P<0.05;χ2=4.452,P<0.05).Conclusion For advanced HCC patients,"quadruple therapy",TACE combined with HAIC,lenvatinib and sintilimab improves the objective response rate,disease control rate and success rate of conversion to surgical resection,and prolongs the mOS and mPFS,which without an increase in perioperative adverse events and complications.关键词
中晚期肝细胞癌/肝动脉化疗栓塞/肝动脉灌注化疗/仑伐替尼/信迪利单抗Key words
advanced hepatocellular carcinoma/transcatheter arterial chemoembolization/hepatic artery infusion chemotherapy/lenvatinib/sindilumab分类
临床医学引用本文复制引用
王远鹏,张国林,康壮壮,刘中,孙万亮,周磊,顾海涛,褚亮..TACE联合HAIC加靶免"四联"疗法对中晚期肝细胞癌的疗效分析[J].肝胆胰外科杂志,2025,37(3):179-184,6.基金项目
安徽省卫生健康科研青年项目(AHWJ2023A30187). （AHWJ2023A30187）
