贝伐珠单抗联合TACE治疗中晚期肝细胞癌的临床疗效观察

Efficacy of bevacizumab combined with TACE in the treatment of advanced hepatocellular carcinoma

目的比较贝伐珠单抗联合TACE与单纯TACE治疗中晚期肝细胞癌的疗效。方法将2018年1月至2019年11月入院治疗的100例中晚期HCC患者根据治疗方案不同分为联合组和TACE组。联合组50例,TACE组50例。比较两组患者的客观缓解率(ORR)、肿瘤控制率(DCR);治疗前后AFP变化情况;两组患者半年和18个月生存率、中位生存时间情况。结果根据3个疗程治疗后的MRI增强提示,联合组ORR为70.0%,TACE组ORR为35.00%,差异有统计学意义(χ^(2)=4.856,P=0.025);联合组DCR为84.00%,TACE组DCR为68.00%,差异有统计学意义(χ^(2)=3.256,P=0.034)。两组患者经治疗后AFP水平均明显下降,治疗前后AFP水平差异均有统计学意义(P<0.05),而两组间比较差异无统计学意义(P>0.05)。联合组半年和18个月生存率分别为90%和50%,均高于TACE组,差异有统计学意义(χ^(2)=4.726,P=0.032和χ^(2)=4.115,P=0.041)。Kaplan-Meier分析显示联合组患者中位生存期18个月,TACE组中位生存时间为9个月(χ^(2)=7.012,P=0.007)。结论贝伐珠单抗联合TACE治疗中晚期肝细胞癌的疗效优于单纯TACE,可有效提高生存率。

Objective To evaluate the safety and efficacy of bevacizumab combined with transcatheter arterial chemoembolization(TACE)versus TACE monotherapy in the treatment of advanced hepatocellular carcinoma(HCC).Methods One hundred patients with advanced HCC admitted to our hospital from January 2018 to November 2019 were enrolled.They were divided into the combined group and the TACE group according to the treatment method.There were 50 cases in each group.The objective response rate(ORR)and tumor control rate(DCR)of 2 groups were compared.The levels of alpha fetoprotein(AFP)before and after treatment,the half-year survival rate,18-month survival rate and median survival time between the 2 groups were compared.Results After 3 courses of treatment,enhanced magnetic resonance imaging(MRI)showed that the ORR of combination group and TACE group were 70.0%and 35.00%respectively,the difference was statistically significant(χ^(2)=4.856,P=0.025);DCR of combination group and TACE group were 84.00%and 68.00%respectively,the difference was statistically significant(χ^(2)=3.256,P=0.034).The AFP level of 2 groups decreased significantly after 3 courses of treatment,the AFP levels before and after treatment were significantly different in each group(P<0.05),and the AFP levels between the 2 groups were not significantly different(P>0.05).The half-year and 18-month survival rates of combined group were 90%and 50%respectively,which were significantly higher than those of TACE group,and the differences were statistically significant(χ^(2)=4.726,P=0.032 andχ^(2)=4.115,P=0.041,respectively).Kaplan-Meier analysis showed that the median survival time of patients in combined group and TACE group were 18 and 9 months,and the difference was statistically significant(χ^(2)=7.012,P=0.007).The position of the survival curve of combination group was higher than that of TACE group,suggesting that the clinical efficacy of combined treatment was better.Conclusion The clinical efficacy of bevacizumab combined with TACE is better than TACE monotherapy in the treatment of advanced HCC,and the combined therapy can effectively improve the survival rate.