TACE联合替雷利珠单抗治疗中晚期原发性肝癌的临床价值

The therapeutic effect of transcatheter arterial chemoembolization combined with toripalimab in 88 patients with advanced primary liver cancer

目的 探讨在肝动脉化疗栓塞(TACE)基础上联合应用替雷利珠单抗治疗中晚期原发性肝癌的效果。方法 本研究为随机对照试验,选取2020年1月—2022年12月于梧州市人民医院肿瘤科、桂东人民医院肝病区就诊的中晚期原发性肝癌患者,随机分为联合治疗组和对照组,对照组患者仅接受TACE介入,联合治疗组在TACE基础上联合应用替雷利珠单抗。比较两组患者的近期疗效、血清肝脏生化指标、肿瘤标志物水平及不良反应发生情况,绘制Kaplan-Meier生存曲线并比较组间生存差异。结果 本研究共纳入88例中晚期原发性肝癌患者,联合治疗组和对照组各44例,两组患者基线资料无异质性(P>0.05)。治疗后,联合治疗组客观缓解率、疾病控制率和完全病理缓解率为61.36%、95.45%和59.09%,均显著高于对照组(分别为36.36%、77.27%和36.36%,P<0.05);联合治疗组肝脏生化指标和肿瘤标志物的表达量均低于对照组(P<0.05);对照组不良反应发生率与联合治疗组未发现显著差异(分别为22.73%和38.64%,P>0.05)。联合治疗组和对照组生存率分别为65.91%(29/44)和43.18%(19/44),Log-rank分析结果表明组间生存情况具有显著差异(χ^(2)=4.900,P=0.027)。结论 TACE联合替雷利珠单抗对中晚期原发性肝癌患者具有显著治疗效果,适宜进一步推广应用。

Objective To explore the therapeutic effect of transcatheter arterial chemoembolization(TACE)combined with toripalimab in patients with advanced primary liver cancer.Methods 88 patients with advanced primary liver cancer admitted to the Department of Oncology of Wuzhou People’s Hospital from January 2020 to December 2022 were randomly divided into an observation group and a control group according to a random number table.The control group was treated with TACE,and the observation group was treated with TACE and toripalimab.The recent efficacy,serum liver biochemical indicators,tumor marker levels,and adverse events were compared between the two groups.The survival curve was conducted and compared by Kaplan-Meier method.Results The baseline data of the two groups of patients before treatment were not heterogeneous(P>0.05).After treatment,the objective remission rate,disease control rate,and complete pathological remission rate of the observation group were 61.36%,95.45%,and 59.09%,respectively,which were significantly higher than those in the control group(36.36%,77.27%,and 36.36%,respectively,P<0.05).The serum alanine aminotransferase,aspartate aminotransferase,total bilirubin,and tumor markers such as carcinoembryonic antigen,alpha-fetoprotein,andα-L-fucosidase in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse events in the control group and observation group was 22.73%and 38.64%,respectively,without statistically significant difference(P>0.05).At the end of follow-up,the survival rates of the observation group was 65.91%(29/44),which was significantly higher than the rate of 43.18%(19/44),in the control group(χ^(2)=4.900,P=0.027).Conclusion TACE combined with toripalimab has significant therapeutic effect in patients with advanced primary liver cancer and is suitable for further promotion and application.