摘要
Abstract
Objective To observe the efficacy of regorafenib combined with programmed death receptor 1(PD-1)inhibitor as second-line treatment for advanced hepatocellular carcinoma(HCC)and to analyze the prognostic in-fluencing factors.Methods Fifty-two patients with advanced HCC were treated with regorafenib combined with PD-1 inhibitor.The treatment effect and adverse reactions were observed.Univariate analysis and multivariate Cox re-gression analysis were used to analyze the prognostic factors of 52 patients with advanced HCC.Results After treatment with regorafenib combined with PD-1 inhibitor,52 patients with advanced HCC achieved complete remis-sion(CR)in 1 case(1.92%),partial remission(PR)in 15 cases(28.85%),stable disease(SD)in 21 cases(40.38%),and progressive disease(PD)in 15 cases(28.85%);the objective response rate(ORR)was 30.77%(16/52),and the disease control rate(DCR)was 71.15%(37/52);the median progression-free survival(mPFS)was 8.4 months,and the median overall survival(mOS)was 15.8 months.The most common adverse re-actions were hand-foot syndrome(25 cases),followed by diarrhea(18 cases)and hypertension(18 cases).Subse-quent reactions in descending order of frequency included fatigue(13 cases),pain(12 cases),nausea(11 cases),anorexia(11 cases),elevated transaminases(11 cases),hyperbilirubinemia(8 cases),hypothyroidism(8 cases),rash(7 cases),vomiting(7 cases),fever(6 cases),foot numbness(4 cases),hemoptysis(4 cases),gastroin-testinal bleeding(3 cases),and gingival bleeding(2 cases).Univariate analysis showed that patients without extra-hepatic metastasis in the past,who had received local treatment in the past,with Child-Pugh grade A,and at BCLC-B stage,had significantly prolonged mPFS,and the differences were statistically significant(all P<0.05);multivari-ate analysis showed that Child-Pugh grade B and BCLC-C stage were independent risk factors for mPFS in patients with advanced HCC treated with regorafenib combined with PD-1 inhibitor.Conclusions Regorafenib combined with PD-1 inhibitor as second-line treatment for advanced HCC patients has significant efficacy and controllable ad-verse reactions.Child-Pugh grade B and BCLC-C stage are independent risk factors affecting the poor prognosis of HCC patients.关键词
瑞戈非尼/程序性死亡受体1抑制剂/肝细胞癌/Child-Pugh分级/BCLC分期Key words
regorafenib/programmed death receptor 1 inhibitor/hepatocellular carcinoma/Child-Pugh grade/BCLC stage分类
临床医学
