射频消融联合TACE+派安普利单抗及安罗替尼治疗晚期肝细胞癌的效果

Efficacy of Radiofrequency Ablation Combined with TACE+ Pembrolizumab and Anlotinib in the Treatment of Advanced Hepatocellular Carcinoma

目的 探究射频消融(RFA)联合肝动脉化疗栓塞(TACE)治疗晚期肝细胞癌(HCC)后给予派安普利单抗、安罗替尼治疗的有效性及安全性,并分析其对肿瘤标志物、免疫功能的影响。方法 选取2022年1月至2023年4月郑州市第三人民医院行RFA联合TACE治疗的晚期HCC患者60例,分为对照组30例(RFA联合TACE治疗后给予安罗替尼治疗)、研究组30例(RFA联合TACE治疗后给予派安普利单抗+安罗替尼治疗)。比较两组近期疗效、肿瘤标志物、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、不良反应发生情况、肝区疼痛程度、生存质量。结果 研究组客观缓解率、疾病控制率、不良反应与对照组比较,差异无统计学意义(P>0.05);与对照组比较,研究组治疗后血清糖类抗原199、甲胎蛋白、热休克蛋白90水平降低(P<0.05);与对照组比较,研究组治疗后外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平升高(P<0.05);与对照组比较,研究组治疗后数字等级量表(NRS)评分降低,欧洲癌症治疗与研究组织生活质量量表核心量表(EORTC QLQ-C30)评分升高(P<0.05)。结论 RFA联合TACE+派安普利单抗及安罗替尼治疗晚期HCC的效果确切,可抑制肿瘤进展,减轻机体免疫抑制,缓解肝区疼痛程度,改善生存质量,延长生存期,且具有一定安全性。

Objective To investigate the efficacy and safety of radiofrequency ablation(RFA)combined with transarterial chemoembolization(TACE)in the treatment of advanced hepatocellular carcinoma(HCC),and to analyze the effects of pembrolizumab and antirotinib on tumor markers and immune function.Methods A total of 60 patients with advanced HCC who received RFA combined with TACE in the Third People’s Hospital of Zhengzhou from January 2022 to April 2023 were selected and divided into control group(30 cases,RFA combined with TACE followed by anlotinib)and study group(30 cases,RFA combined with TACE followed by pembrolizumab plus anlotinib).The recent efficacy,tumor markers,T lymphocyte subsets(CD3^(+),CD4^(+),CD4^(+)/CD8^(+)),incidence of adverse reactions,degree of liver pain,and quality of life were compared between two groups.Results There were no significant differences in objective response rate,disease control rate and adverse reactions between the study group and the control group(P>0.05).Compared with the control group,the levels of serum carbohydrate antigen 199,alpha fetoprotein and heat shock protein 90 in the study group were decreased after treatment(P<0.05).Compared with the control group,the levels of peripheral blood CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the study group were increased after treatment(P<0.05).Compared with the control group,the numerical rating scale(NRS)score of the study group decreased after treatment,while the European Organization for Research and Treatment of Cancer quality of life core 30(EORTC QLQ-C30)score increased(P<0.05).Conclusion RFA combined with TACE+papriprizumab and anlotinib are effective in the treatment of advanced HCC,which can inhibit tumor progression,alleviate immune suppression,relieve liver pain,improve quality of life,prolong survival,and have certain safety.