Efficacy of targeted therapy combined with TACE in the treatment of patients with advanced primary liver cancer and its effects on peripheral blood RASSF1A gene methylation
Objective To analyze the efficacy of apatinib targeted therapy combined with transhepatic arterial chemotherapy and embolization(TACE)in the treatment of patients with advanced primary liver cancer and the effects on Ras association domain family 1A(RASSF1A)gene methylation of peripheral blood.Methods A total of 64 patients with advanced hepatic cell carcinoma(HCC)were selected as research subjects,and were randomly divided into the single group(n=32)and combined group(n=32).The single group received TACE therapy,and the combined group was given apatinib targeted therapy combined with TACE therapy.Both groups received standard course of TACE therapy,and 3 months of treatment was taken as the observation endpoint.The clinical efficacy in the two groups was evaluated,and the liver function[albumin(ALB),total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)],serum markers[alpha-fetoprotein(AFP),vascular endothelial growth factor(VEGF),cysteinyl aspartate protease 8(caspase-8)]and peripheral blood RASSF1A gene methylation were compared before and after treatment,and the treatment-related adverse reactions were recorded.The incidence rates of TACE resistance in the two groups was evaluated by continuous follow-up observation.Results The objective response rate(ORR)after 3 mo of treatment in the single group decreased compared with that after 1 mo of treatment(P＜0.05),and was lower than that in combined group(P＜0.05).After 3 mo of treatment,the levels of ALT and AST in both groups decreased compared with before treatment(P＜0.05),and the levels were lower in the combined group than those in the single group(P＜0.05);the level of AFP was significantly declined in both groups compared with that before treatment(P＜0.05),and the VEGF level in the combined group was reduced(P＜0.05)while the caspase-8 level was enhanced compared with that before treatment(P＜0.05),and the levels of AFP and VEGF in the combined group after 3 mo of treatment were lower than those in the single group(P＜0.05)while the level of caspase-8 was higher than that in the single group(P＜0.05).After treatment,the positive rates of peripheral blood RASSF1A gene methylation in the two groups showed a decreasing trend,but there was no statistical significance within the single group(P＞0.05).The positive rate of RASSF1A gene methylation in the combined group was significantly lower after 3 mo of treatment than that before treatment(P＜0.05).The adverse reactions of the two groups were mainly grade 1-2,which were improved after symptomatic treatment.The incidence rates of hand-foot syndrome and hypertension were higher(P＜0.05),and the incidence rate of TACE resistance was slightly lower(P＞0.05).Conclusion Apatinib targeted therapy combined with TACE in the treatment of advanced HCC possesses good efficacy and safety,and it is beneficial to reducing RASSF1A gene methylation.
hepatic cell carcinomaadvancedtargeted therapyapatinibtranshepatic arterial chemotherapy and embolizationRASSF1A gene methylation
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