经肝动脉灌注化疗或化疗栓塞术联合酪氨酸激酶抑制剂及卡瑞利珠单抗治疗不可切除肝细胞癌的对比研究
Hepatic arterial infusion chemotherapy versus transarterial chemoembolization combined with tyrosine kinase inhibitors and camrelizumab for unresectable hepatocellular carcinoma:a comparative study
陈路皓 1杨奕 1张精文 1刘琦 1卢俊蓉 1侯英文 1刘岩1
作者信息
- 1. 150006 黑龙江哈尔滨 哈尔滨医科大学附属肿瘤医院介入科
- 折叠
摘要
目的 探索经导管动脉化疗栓塞(transarterial chemoembolization,TACE)及肝动脉灌注化疗(hepatic artery infusionchemotherapy,HAIC)联合酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKI)及免疫检查点抑制剂(immune checkpoint inhibitors,ICI)治疗中晚期肝细胞癌(HCC)的疗效及安全性.方法 纳入2021年1月至2022年10月哈尔滨医科大学附属肿瘤医院HCC患者101例,其中50例患者接受TACE+TKI+ICI治疗,51例患者接受HAIC+TKI+ICI治疗.比较两组的OS、PFS,并对不良事件进行分析以评估方案的安全性.结果 TACE+TKI+ICI组中位PFS为12.0个月,HAIC+TKI+ICI组为11.0个月(P=0.030).TACE+TKI+ICI 组中位 OS 未达到,HAIC+TKI+ICI 组为 14.6 个月(P=0.005).TACE+TKI+ICI组最常见的不良反应是总胆红素升高(46.0％)及肝功能损伤(26.0％),HAIC+TKI+ICI组则为白蛋白降低(62.7％)、乏力(39.2％)及胃肠道反应(31.4％).结论 TACE+TKI+ICI方案有着更佳的远期生存获益,而HAIC+TKI+ICI方案能更好地维持患者的肝功能储备,两种方案均未出现意外的毒性反应,安全性较高.
Abstract
Objective To discuss the efficacy and safety of transarterial chemoembolization(TACE)and hepatic arterial infusion chemotherapy(HAIC)combined with tyrosine kinase inhibitors(TKI)and immune checkpoint inhibitors(ICI)for advanced hepatocellular carcinoma(HCC).Methods A total of 101 patients with unresectable HCC,who were admitted to the Affiliated Cancer Hospital of Harbin Medical University of China between January 2021 and October 2022 to receive treatment,were enrolled in this study.Of the 101 patients,50 received TACE+TKI+ICI therapy(TACE+TKI+ICI group)and 51 received HAIC+TKI+ICI therapy(HAIC+TKI+ICI group).The overall survival(OS)and the progression-free survival(PFS)were compared between the two groups,and the adverse events were analyzed to assess the safety of the therapeutic scheme.Results The median PFS in the TACE+TKI+ICI group was 12.0 months,which in the HAIC+TKI+ICI group was 11.0 months(P=0.030).The median OS was not achieved in the TACE+TKI+ICI group,which in the HAIC+TKI+ICI group was 14.6 months(P=0.005).The most common adverse effects in the TACE+TKI+ICI group were the elevation of total bilirubin(46.0％)and hepatic function injury(26.0％),which in the HAIC+TKI+ICI group were the decrease of albumin level(62.7％),fatigue(39.2％),and gastrointestinal reactions(31.4％).Conclusion For the treatment of advanced HCC,the therapeutic scheme of TACE+TKI+ICI has a better long-term survival benefits and the therapeutic scheme of HAIC+TKI+ICI can better maintain the liver function reserve of the patients.Neither therapeutic scheme shows any unexpected toxicity,and both therapeutic schemes have high clinical safety.(J Intervent Radiol,2024,33:543-548)
关键词
肝细胞癌/经导管肝动脉化疗灌注术/经导管肝动脉化疗栓塞术/酪氨酸激酶抑制剂/免疫治疗/联合疗法Key words
hepatocellular carcinoma/hepatic arterial infusion chemotherapy/transcatheter arterial chemoembolization/tyrosine kinase inhibitor/immunotherapy/combination therapy引用本文复制引用
出版年
2024
NETL
NSTL
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