仑伐替尼联合经导管动脉栓塞化疗治疗老年原发性肝癌的疗效

Effect of lenvatinib combined with transcatheter arterial chemoembolization in the treatment of elderly patients with primary liver cancer

目的探讨仑伐替尼联合经导管动脉栓塞化疗(TACE)治疗老年原发性肝癌患者的疗效。方法将94例老年原发性肝癌患者按治疗方案不同分为对照组60例和观察组34例,对照组接受TACE治疗,观察组接受仑伐替尼联合TACE治疗。比较两组患者临床疗效、肝功能指标[天冬氨酸转氨酶(AST)、总胆红素(TBIL)、丙氨酸转氨酶(ALT)]、免疫功能指标(CD3^(+)、CD4^(+)及CD8^(+)T细胞)、肿瘤标志物[血清甲胎蛋白(AFP)及癌胚抗原(CEA)]水平、不良反应及预后情况。结果观察组患者客观缓解率、疾病控制率均高于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者血清AST、TBIL、ALT水平均较本组治疗前升高,且观察组患者血清AST、TBIL、ALT水平均低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者CD3^(+)、CD4^(+)水平均较本组治疗前升高,CD8^(+)水平均较本组治疗前降低,且观察组患者CD3^(+)、CD4^(+)水平均高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者血清AFP、CEA水平均较本组治疗前降低,且观察组患者血清AFP、CEA水平均低于对照组,差异均有统计学意义(P﹤0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P﹥0.05)。观察组患者疾病进展时间(TTP)、总生存时间(OS)均优于对照组患者,差异均有统计学意义(P﹤0.05)。结论仑伐替尼联合TACE治疗老年原发性肝癌可获得显著效果,可显著降低AFP、CEA水平,抑制肿瘤进展,且联合治疗不增加严重不良反应,值得推荐。

Objective To investigate the effect of lenvatinib combined with transcatheter arterial chemoembolization(TACE)in the treatment of elderly patients with primary liver cancer.Method A total of 94 elderly patients with prima-ry liver cancer were divided into two groups according to different treatment schemes,including 60 patients treated with TACE as the control group and 34 patients treated with lenvatinib combined with TACE as the observation group.The clinical efficacy,liver function index[aspartate aminotransferase(AST),total bilirubin(TBIL),alanine aminotransferase(ALT)],immune function index(CD3^(+),CD4^(+)and CD8^(+)T cells),tumor marker[serum alpha fetoprotein(AFP)and car-cinoembryonic antigen(CEA)]levels,adverse reactions and prognosis were compared between the two groups.Result The objective response rate(ORR)and disease control rate(DCR)of the observation group were significantly higher than those of the control group,the differences were statistically significant(P<0.05).After treatment,the levels of serum AST,TBIL and ALT in the two groups were higher than those before treatment,and the levels of serum AST,TBIL and ALT in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of CD3^(+),CD4^(+)in the two groups were higher than those before treatment,CD8^(+)were lower than those before treatment,and the levels of CD3^(+),CD4^(+)in the observation group were higher than those in the control group,CD8^(+)was lower than that in the control group(P<0.05).After treatment,the levels of serum AFP,CEA in the two groups were lower than those before treatment,and the levels of serum AFP,CEA in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).The time to progression(TTP)and overall survival(OS)of the observation group were better than those of the control group(P<0.05).Conclusion Lenvatinib combined with TACE in the treatment of elderly patients with primary liver cancer can achieve significant effects,significantly reduce the levels of AFP and CEA,inhibit tumor progression,without increasing the incidence of serious adverse reactions,which is recommended.