肝胆胰外科杂志2026，Vol.38Issue(2)：103-109,7.DOI:10.11952/j.issn.1007-1954.2026.02.005
肝动脉灌注化疗联合靶免治疗对合并门静脉癌栓的大肝癌短期效果分析
Short-term efficacy of hepatic arterial infusion chemotherapy combined with targeted-immune therapy in patients with large hepatocellular carcinoma complicated by portal vein tumor thrombus
摘要
Abstract
Objective To investigate the short-term efficacy and safety of hepatic arterial infusion chemotherapy(HAIC)combined with targeted-immune therapy versus targeted-immune therapy alone in patients with large hepatocellular carcinoma(HCC)complicated by portal vein tumor thrombus(PVTT).Methods A retrospective study was conducted on 63 patients with large HCC and PVTT,who were admitted to the Second Affiliated Hospital of Wenzhou Medical University between January 2022 and April 2023.Thirty-three patients in the observation group received HAIC plus lenvatinib and tislelizumab(interventional-combined targeted-immune therapy),while 30 patients in the control group received lenvatinib and tislelizumab alone(targeted-immune therapy).The primary outcomes included objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS),overall survival(OS),and incidence of treatment-related adverse events.Results In terms of treatment efficacy,the observation group demonstrated significantly higher ORR(78.8%vs 46.7%,χ2=6.995,P=0.008)and DCR(90.9%vs 66.7%,χ2=5.639,P=0.018)compared with the control group.Regarding survival outcome,the median PFS was significantly longer in the observation group[95%CI(5.13 to 6.87)months vs 95%CI(3.12 to 4.88)months],the PFS rate at 6 months after treatment was higher in the observation group(43.5%vs 29.6%,χ2=7.341,P=0.007).Similarly,the median OS was significantly improved in the observation group[95%CI(10.86 to 17.13)months vs 95%CI(7.99 to 12.01)months],the cumulative OS rate at 12 months after treatment was higher in the observation group(53.6%vs 30.0%,χ2=8.521,P=0.004).In terms of safety,the observation group had a significantly higher incidence of neutropenia and thrombocytopenia(42.4%vs 10.1%,χ2=8.385,P=0.004).However,no statistically significant difference was observed in other treatment-related adverse events between the two groups(P>0.05).Conclusion For patients with large HCC and PVTT,HAIC combined with targeted-immune therapy may significantly improve the short-term ORR and DCR,prolong both PFS and OS,and exhibit a manageable safety profile compared with targeted-immune therapy alone.This combination represents a promising therapeutic strategy for patients with large HCC and PVTT.关键词
肝细胞癌/门静脉癌栓/大肝癌/肝动脉灌注化疗/靶免治疗/仑伐替尼/替雷利珠单抗Key words
hepatocellular carcinoma/portal vein tumor thrombus/large hepatocellular carcinoma/hepatic arterial infusion chemotherapy/targeted-immune therapy/lenvatinib/tislelizumab分类
医药卫生引用本文复制引用
张东,姚红响,王兆洪,杨琰..肝动脉灌注化疗联合靶免治疗对合并门静脉癌栓的大肝癌短期效果分析[J].肝胆胰外科杂志,2026,38(2):103-109,7.基金项目
温州市科技局基础性医疗卫生科技项目(Y20211054). （Y20211054）
