TACE联合仑伐替尼和信迪利治疗超出up-to-seven标准的原发性肝癌患者临床疗效研究*

doi:10.3969/j.issn.1672-5069.2025.05.033

摘要/Abstract

摘要： 目的探讨经肝动脉化疗栓塞术(TACE)联仑伐替尼和信迪利单抗治疗超出up-to-seven标准的原发性肝癌(PLC)患者的临床疗效。方法 2021年6月～2024年9月我院收治的超出up-to-seven标准的PLC患者96例,其中观察组48例接受TACE联合仑伐替尼和信迪利单抗治疗,对照组48例接受TACE联合仑伐替尼治疗。依据mRECIST评价肿瘤治疗效果,应用单因素和多因素Cox回归分析PLC患者无进展生存期(PFS)的影响因素。结果观察组客观缓解率(ORR)和疾病控制率(DCR)分别为43.8%和89.6%,均显著高于对照组的22.9%和72.9%(P<0.05);观察组中位PFS为15.3个月,中位总生存期(OS)为23.0个月,均显著长于对照组(分别为11.2个月和15.0个月,P<0.05);Cox多因素回归分析显示,治疗方法、门静脉癌栓(PVTT)和血清AFP>400 μg/L是影响PFS的独立危险因素(P<0.05)。结论采用TACE联合仑伐替尼和信迪利单抗治疗超出up-to-seven标准的PLC患者可以有效减轻肿瘤负荷,延长生存时间。

关键词: 原发性肝癌, 肝动脉栓塞化疗, 信迪利单抗, 仑伐替尼, 治疗

Abstract: Objective The aim of this study was to investigate the clinical efficacy of transcatheter arterial chemoembolization (TACE) in combination with lenvatinib and sintilimab in treating patients with exceeding up-to-seven criteria primary liver cance (PLC). Methods 96 patients with PLC beyond the up-to-seven criteria were admitted to our hospital between June 2021 and September 2024, 48 patients in the observation group received TACE with combination of lenvatinib and sintilimab, and another 48 patients in the control group received TACE in combination with lenvatinib alone. Tumor response was evaluated based on mRECIST criteria. Univariate and multivariate Cox regression analysis were performed to identify factors influencing progression-free survival (PFS) in PLC patients. Results The objective response rate (ORR) and disease control rate (DCR) in the observation group were 43.8% and 89.6%,both significantly higher than 22.9% and 72.9% in the control group (P<0.05); the progression-free survival (mPFS) and overall survival (OS) in the observation group were 15.3 months and 23.0 months , both significantly higher than 11.2 months and 15.0 months in control group (P<0.05); the multivariate Cox regression analysis identified that the treatment regimen, portal vein tumor thrombus (PVTT) and serum AFP >400μg/L were the independent prognostic factors affecting PFS(P<0.05). Conclusion The combination of lenvatinib and sintilimab after TACE could effectively reduce tumor burdens and prolong survival in patients with PLC exceeding the up-to-seven criteria.

Key words: Hepatoma, Transcatheter arterial chemoembolization, Sintilimab, Lenvatinib, Therapy

王佳会, 崔立明. TACE联合仑伐替尼和信迪利治疗超出up-to-seven标准的原发性肝癌患者临床疗效研究^*[J]. 实用肝脏病杂志, 2025, 28(5): 771-775.

Wang Jiahui, Cui Liming. TACE in combination with lenvatinib and sintilimab in the treatment of patients with beyondup-to-seven criteria hepatocellular carcinoma[J]. Journal of Practical Hepatology, 2025, 28(5): 771-775.

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TACE联合仑伐替尼和信迪利治疗超出up-to-seven标准的原发性肝癌患者临床疗效研究^*

TACE in combination with lenvatinib and sintilimab in the treatment of patients with beyondup-to-seven criteria hepatocellular carcinoma

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