Objective:To compare the efficacy and safety of microwave ablation(MWA)combined with lenvatinib and hepatic artery infusion chemotherapy(HAIC)with hepatic artery chemoembolization(TACE)for the treatment of progressive primary hepatocellular carcinoma(HCC).Methods:Clinical case data of 96 patients who received MWA combined with lenvatinib and HAIC or TACE combined for the treatment of progressive HCC at the Affiliated Hospital of Chuanbei Medical College from October 2019 to October 2022 were collected using a retrospective evaluation method.Among them,43 patients were treated with MWA combined with lenvatinib and HAIC regimen,and 53 patients were treated with MWA combined with lenvatinib and TACE regimen.Objective remission rate(ORR),disease control rate(DCR),incidence of adverse events,disease progression-free survival(PFS)and overall survival(OS)were assessed according to mRECIST evaluation criteria.Results:The overall efficacy evaluation ORR was 67.4%and DCR was 84.4%for 43 patients in the HAIC combination therapy group.The overall efficacy evaluation ORR was 32.1%and DCR was 69.8%for 53 patients in the TACE combination therapy group.The median PFS for the HAIC combination therapy group and the TACE combination therapy group was 13 months(95%CI 8-18),9 months(95%CI 7.2-10.8)(P=0.042).The median OS was 18 months(95%CI 11-25)and 14 months(95%CI 10.7-17.3)in the two groups,respectively(P=0.342).Major adverse effects in the HAIC combination therapy group were vomiting,abdominal pain,lower extremity venous thrombosis and chemotherapy-related bone marrow suppression,while the major adverse effects in the TACE combination therapy group were fever,abdominal pain,liver function abnormalities and thrombocytopenia.And there were no treatment-related deaths in both groups.Conclusion:MWA combined with lenvatinib and HAIC for the treatment of progressive HCC had a higher PFS and a lower incidence of adverse events than MWA combined with lenvatinib and TACE for the treatment of progressive HCC.
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