肝动脉化疗栓塞联合仑伐替尼治疗局部晚期肝细胞癌的临床效果

Clinical Efficacy of Hepatic Artery Chemoembolization Combined with Lenvatinib in the Treatment of Locally Advanced Hepatocelluar Carcinoma

目的观察肝动脉化疗栓塞术(TACE)联合甲磺酸仑伐替尼胶囊靶向治疗局部晚期肝细胞癌(HCC)患者的临床效果和药物不良反应。方法选择2021年1月至2022年10月在河南大学第一附属医院肿瘤科确诊的78例局部晚期HCC患者,根据随机数表法分为治疗组和对照组,每组39例。给予对照组TACE治疗,给予治疗组甲磺酸仑伐替尼胶囊联合TACE治疗。观察两组客观缓解率(ORR)、疾病控制率(DCR)以及中位总生存期(OS)、中位无进展生存期(PFS),比较两组异常凝血酶原(DCP)、高尔基体蛋白73(GP73)和甲胎蛋白(AFP)表达水平。结果治疗组ORR、DCR分别为56.41%、74.36%,高于对照组的33.33%、46.15%(P<0.05)。治疗组血清DCP、GP73和AFP表达水平低于对照组(P<0.05)。治疗组高血压、疲乏、关节肌肉痛和蛋白尿发生率高于对照组(P<0.05)。治疗组中位PFS和中位OS分别为11.6、18.5个月,长于对照组的7.2、13.8个月(P<0.05)。结论TACE联合甲磺酸仑伐替尼胶囊在不可手术切除的局部晚期HCC患者中临床疗效可靠,可延长患者生存时间,不良反应可控可耐受,且可降低血清DCP、GP73和AFP表达水平,为临床治疗提供新的选择。

Objective To observe the clinical efficacy and adverse drug reaction of transcatheter arterial chemoembolization(TACE)combined with ranvartinib mesylate targeted therapy in patients with locally advanced hepatocelluar carcinoma(HCC).Methods From January 2021 to October 2022,seventy-eight patients with locally advanced HCC diagnosed in the Oncology Department of the First Affiliated Hospital of Henan University were selected.They were randomly divided into a treatment group and a control group,with 39 patients in each group.The control group patients were only treated with TACE,while the treatment group patients were treated with lenvatinib mesylate capsules combined with TACE.Objective response rate(ORR),disease control rate(DCR),median overall survival(OS),median progression-free survival(PFS)and the influence on the expression levels of serum des-gamm-carboxy prothrombin(DCP),Golgi apparatus protein 73(GP73)and alpha fetoprotein(AFP)were observed.Results The ORR and DCR of patients in the treatment group(56.41%and 74.36%)were higher than those(33.33%and 46.15%)in the control group(P<0.05).The expression levels of serum DCP,GP73 and AFP in the treatment group were lower than those in the control group(P<0.05).The incidence of hypertension,fatigue,joint myalgia and proteinuria in the treatment group was higher than that in the control group(P<0.05).The median PFS and median OS in the treatment group were 11.6 and 18.5 months,respectively,which were longer than those in the control group at 7.2 and 13.8 months(P<0.05).Conclusion TACE combined with lenvatinib mesylate capsules has reliable clinical efficacy in locally advanced HCC patients who cannot be surgically removed,prolongs patient survival time,tolerates controllable adverse reactions,and reduces serum DCP,GP73 and AFP expression levels,providing a new choice for clinical treatment.