DEB-TACE联合仑伐替尼治疗不可切除大肝癌合并门脉癌栓疗效

Efficacy and safety of DEB-TACE combined with lenvatinib in the treatment of hepatocellular carcinoma with portal vein tumor thrombus

目的:探讨载药微球-肝动脉化疗栓塞术(DEB-TACE)联合仑伐替尼治疗不可切除大肝癌合并门脉癌栓的临床效果和安全性。方法:临沂市肿瘤医院2019年6月至2021年6月收治不可切除大肝癌合并门脉癌栓患者50例,随机分为试验组(23例)和对照组(27例);对照组接受DEB-TACE治疗,试验组接受DEB-TACE联合仑伐替尼治疗。评估术后短期治疗效果,随访统计患者生存情况,并记录有关仑伐替尼的不良反应。结果:治疗后3个月,试验组的客观缓解率、疾病控制率为91.31%、100%,对照组为66.67%、66.67%(P均<0.05)。治疗后3月,试验组和对照组癌栓消退率为60.87%、29.63%(P<0.05)。试验组和对照组无进展生存期为11月、8月(P<0.05);试验组和对照组中位生存期20月、14个月(P<0.05)。试验组服用仑伐替尼主要不良反应为高血压、腹泻、手足综合征、皮疹、乏力、食欲下降等,均≤3级,经对症处理后基本可缓解。结论:PDEB-TACE联合仑伐替尼治疗不可切除大肝癌合并门脉癌栓安全性、耐受性良好,可有效控制肿瘤进展,延长患者生存期。

Objective:To assess the efficiency and safety of combining lenvatinib with DEB-TACE for the treatment of unresectable large hepatocellular carcinoma,accompanied by PVTT,in order to provide insights into its potential as a therapeutic approach.Method:Patients with hepatocellular carcinoma and portal vein tumor thrombus,who were diagnosed and treated at Linyi Cancer Hospital between June 2019 and June 2021,were chosen as the subjects of this study.Patient allocation into the experimental group(23 cases)and control group(27 cases)was based on individual preferences,ensuring a random distribution of participants.The DEB-TACE treatment was administered to the control group,while the experimental group received a combination of DEB-TACE and lenvatinib.The effectiveness of lenvatinib was assessed in the immediate post-surgery period,the patients'survival was monitored,and any associated side effects were documented.Result:3 months after treatment,the objective remission rates of the experimental group and the control group were 91.31%and 66.67%,and the disease control rates were 100%and 77.78%.The difference was statistically significant(P<0.05).3 months after treatment,the regression rates of tumor thrombus in the experimental group and the control group were 60.87%and 29.63%,the difference was statistically significant(P<0.05).The progression free survival time of the experimental group and the control group was 11 months and 8 months,the difference was statistically significant(P<0.05);The median survival time of the experimental group and the control group was 20 months and 14 months,and the difference was statistically significant(P<0.05).The main adverse reactions of the experimental group were hypertension,diarrhea,hand foot syndrome,rash,fatigue,loss of appetite,etc.,all of which were less than or equal to grade 3,and could be basically relieved after symptomatic treatment.Conclusion:The combination of DEB-TACE and lenvatinib is proven to be a safe and well-tolerated treatment for unresectable large hepatocellular carcinoma with portal vein tumor thrombus.This therapy not only effectively controls tumor progression but also prolongs survival time.