TACE联合仑伐替尼联合MWA治疗中晚期大肝癌的疗效评价

Evaluation of the efficacy of TACE combined with Lenvatinib combined with MWA in the treatment of advanced large hepatocellular carcinoma

目的评价肝动脉化疗栓塞术(TACE)联合仑伐替尼联合微波消融(MWA)治疗中晚期大肝癌的临床效疗效。方法选取2018年1月—2021年12月期间中国医学科学院北京协和医学院肿瘤医院和北京市第二医院收治的中晚期大肝癌患者共73例。其中肝动脉化疗栓塞术联合仑伐替尼联合微波消融治疗的患者36例,为观察组;TACE联合仑伐替尼治疗的患者37例,为对照组,对比两组患者的近期疗效、无进展生存期、总生存率及并发症的发生情况。结果观察组和对照组在4个月后的疾病有效缓解率分别为72.2%、40.5%,具有显著性差异(P<0.05)。观察组的中位无进展生存期为18个月,对照组的中位无进展生存期为10个月,两组差异有统计学意义(P<0.05)。观察组的6、12、18、24、36个月的总生存率分别为97.2%、82.7%、70.1%、54.1%、22.3%,对照组的6、12、18、24、36个月总生存率分别为94.6%、66.9%、35.4%、32.2%、9.7%。观察组总生存率明显高于对照组(P<0.05)。两组术后并发症发生率差异无统计学意义(P>0.05)。结论肝动脉化疗栓塞术联合仑伐替尼联合微波消融治疗中晚期大肝癌,可强化疗效并有效延长患者的生存时间。

Objective To evaluate the clinical efficacy of transcatheter arterial chemoembolization(TACE)combined with Lenvatinib and microwave ablation(MWA)in the treatment of advanced large hepatocellular carcinoma.Methods Select 73 patients with advanced large hepatocellular carcinoma admitted to the Peking Union Medical College,Chinese Academy of Medical Sciences and the Second Hospital of Beijing from January 2018 to December 2021.36 patients were treated with TACE combined with Lenvatinib and MWA,were set as observation group;37 patients were treated with TACE combined with Lenvatinib were set as the control group.The short-term efficacy,progression-free survival,total survival rate and complications of the two groups were compared.Results The effective remission rates of the disease in the observation group and the control group after 4 months were 72.2%and 40.5%respectively,with a significant difference(P<0.05).The median progression-free survival was 18 months in the observation group and 10 months in the control group.There was a significant difference between the two groups(P<0.05).The total survival rates at 6,12,18,24 and 36 months in the observation group were 97.2%,82.7%,70.1%,54.1%and 22.3%,respectively,and the total survival rates at 6,12,18,24 and 36 months in the control group were 94.6%,66.9%,35.4%,32.2%and 9.7%respectively.The total survival rate of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion TACE combined with Lenvatinib combined with MWA in the treatment of middle and advanced large liver cancer can strengthen the curative effect and effectively prolong the survival time of patients.