经导管动脉化疗栓塞术联合仑伐替尼或多纳非尼靶向治疗中晚期肝癌的效果及安全性对比研究

A Comparative Study on the Efficacy and Safety of Transcatheter Arterial Chemoemboliztion Combined with Lenvatinib or Donafenib in Targeted Therapy for Liver Cancer in Intermediate to Advanced Stage

目的:探讨经导管动脉化疗栓塞(TACE)术联合仑伐替尼或多纳非尼靶向治疗中晚期肝癌的临床效果及安全性。方法:选取2020年1月~2020年12月期间于某院就诊并接受治疗的149例中晚期且不具有手术指征的原发性肝癌患者作为研究对象,采用简单随机抽样方法分为A组(TACE+仑伐替尼治疗组,n=74)与B组(TACE+多纳非尼治疗组,n=75)。比较两组患者肿瘤血管因子[血管内皮生长因子受体-2(VEGFR-2)]、肿瘤标志物[甲胎蛋白(AFP)、高尔基体蛋白73(GP73)]水平、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)]、临床疗效及不良反应发生情况。结果:治疗后,两组患者VEGFR-2水平降低(P<0.05),且B组低于A组(P<0.05);两组患者AFP和GP73水平均降低(P<0.05);两组ALT、AST和LDH水平均降低(P<0.05)。B组的疾病控制率(DCR)和客观缓解率(ORR)均高于A组(P<0.05)。两组患者不良反应发生率比较无统计学差异(P>0.05)。结论:TACE联合仑伐替尼及多纳非尼靶向治疗均可控制中晚期且不具有手术指征的原发性肝癌患者的病情,具有一定的临床疗效,TACE联合多纳非尼靶向治疗的临床效果更优。

Objective:To investigate the clinical efficacy and safety of transcatheter arterial chemoembolization(TACE)combined with lenvatinib or donafenib targeted therapy in treating patients with intermediate to advanced liver cancer.Methods:A total of 149 patients with intermediate to advanced primary liver cancer who received treatment at a specific hospital from January to December 2020 were enrolled.They were divided into Group A(TACE+lenvatinib treatment,n=74)and Group B(TACE+donafenib treatment,n=75)using simple random sampling.The levels of vascular endothelial growth factor receptor-2(VEGFR-2),tumor markers[alpha-fetoprotein(AFP),Golgi protein 73(GP73)],and liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST),lactate dehydrogenase(LDH)]were compared between the two groups,along with clinical efficacy and incidence of adverse reactions.Results:After treatment,the levels of VEGFR-2 were reduced in both groups(P<0.05),and were lower in Group B than in Group A(P<0.05).The levels of AFP and GP73 were also reduced in both groups(P<0.05);The levels of ALT,AST,and LDH were lowered in both groups(P<0.05).The disease control rate(DCR)and objective response rate(ORR)in Group B were higher than those in Group A(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Both TACE combined with lenvatinib and TACE combined with donafenib can effectively control the disease in patients with intermediate to advanced primary liver canaer who are not candidates for surgery,with clinical efficacy.TACE combined with donafenib targeted therapy has superior clinical outcomes.