肝动脉化疗栓塞术联合卡瑞利珠单抗和仑伐替尼治疗不可切除肝细胞癌的效果和安全性

Efficacy and safety of transcatheter arterial chemoembolization combined with camrelizumab and lenvatinib in treatment of unresectable hepatocellular carcinoma

目的分析肝动脉化疗栓塞术(TACE)联合卡瑞利珠单抗和仑伐替尼治疗不可切除肝细胞癌(HCC)的效果和安全性。方法抽取2019年6月至2022年6月洛阳市东方人民医院收治的不可切除HCC患者72例,按照随机数字表法分为对照组和研究组,每组36例。对照组采用TACE治疗,研究组在对照组基础上采用卡瑞利珠单抗联合仑伐替尼治疗。对比两组临床疗效、治疗后肿瘤最大径、不良反应发生率。结果研究组客观缓解率(50.00%,18/36)、疾病控制率(88.89%,32/36)高于对照组(22.22%,8/36;69.44%,25/36),P<0.05;治疗后,研究组肿瘤最大径小于对照组(P<0.05);研究组甲状腺功能减退、蛋白尿、血尿酸升高、感觉异常、肝功能不全、腹痛、便秘、腹泻、恶心呕吐、皮疹、发热发生率分别为19.44%、13.89%、13.89%、11.11%、30.56%、47.22%、11.11%、11.11%、36.11%、16.67%、8.33%,与对照组的8.33%、8.33%、5.56%、8.33%、44.44%、63.89%、16.67%、11.11%、47.22%、11.11%、13.89%比较,差异未见统计学意义(P>0.05)。结论卡瑞利珠单抗联合仑伐替尼的TACE在不可切除的HCC患者中能显著提升疗效,缩小肿瘤直径,且不会增加不良反应。

Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE)combined with camrelizumab and lenvatinib in the treatment of unresectable hepatocellular carcinoma(HCC).Methods A total of 82 patients with unresectable HCC treated in Luoyang Dongfang People’s Hospital from June 2019 to June 2022 were selected,and they were divided into control group and study group according to the random number table method,with 36 cases in each group.The control group was treated by TACE,and the study group was treated with camrelizumab and lenvatinib based on the treatment of the control group.The clinical efficacy,tumor major diameter and incidence of adverse reactions were compared between the two groups.Results The objective response rate(50.00%,18/36)and disease control rate(88.89%,32/36)in the study group were higher than those in the control group(22.22%,8/36;69.44%,25/36),P<0.05.After treatment,the tumor major diameter of the study group was smaller than that of the control group(P<0.05).The incidence of hypothyroidism(19.44%),proteinuria(13.89%),elevated blood uric acid(13.89%),sensory abnormalities(11.11%),liver dysfunction(30.56%),abdominal pain(47.22%),constipation(11.11%),diarrhea(11.11%),nausea and vomiting(36.11%),rash(16.67%),and fever(8.33%)in the study group were significantly different from those in the control group(8.33%,8.33%,5.56%,8.33%,44.44%,63.89%,16.67%,11.11%,47.22%,11.11%,13.89%),respectively(P>0.05).Conclusions TACE in combination with camrelizumab and lenvastinib can significantly improve therapeutic effec on unresectable HCC patients,and reduce tumor diameter,without increasing adverse effects.