经肝动脉灌注化疗栓塞术联合仑伐替尼治疗中晚期肝细胞癌患者临床疗效研究*

doi:10.3969/j.issn.1672-5069.2026.02.032

摘要/Abstract

摘要： 目的分析经肝动脉化疗栓塞术(TACE)联合仑伐替尼治疗中晚期肝细胞癌(HCC)患者的临床疗效。方法 2021年2月～2025年1月我院收治的中晚期HCC患者92例,被随机分为对照组46例和联合组46例,分别给予TACE治疗或在TACE治疗后给予仑伐替尼维持治疗3个月。复查影像学,评估客观缓解率(ORR)和疾病控制率(DCR)。采用ELISA法检测血清癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、甲胎蛋白(AFP)、碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)和肝细胞生成因子(HGF)水平。结果联合组ORR和DCR分别为41.3%和78.3%,均显著高于对照组的21.7%和54.3%(P<0.05);治疗后,联合组血清CA19-9和AFP水平分别为(28.2±3.3)KU/L和(342.9±42.7)ng/mL,均显著低于对照组【分别为(40.2±4.6)KU/L和(427.9±46.9)ng/mL,P<0.05】;联合组血清bFGF、VEGF和HGF水平分别为(118.2±13.5)ng/L、(326.5±36.9)ng/L和(70.6±8.7)ng/mL,均显著低于对照组【分别为(138.9±15.2)ng/L、(427.5±46.2)ng/L和(92.7±10.6)ng/mL,P<0.05】;在治疗期间,联合组发生了一些皮疹、毛细血管增生和蛋白尿等不良反应。结论在TACE 治疗后加用仑伐替尼口服维持治疗中晚期 HCC 患者具有显著的临床疗效,在提高肿瘤缓解率的同时,能降低血清肿瘤标志物水平,可能与其抑制了肿瘤生长有关。

关键词: 肝细胞癌, 中晚期, 仑伐替尼, 肝动脉化疗栓塞术, 治疗

Abstract: Objective The aim of this study was to investigate the clinical efficacy of lenvatinib therapy after transarterial chemoembolization (TACE) in the treatment of patients with advanced hepatocellular carcinoma (aHCC). Methods A total of 92 patients with aHCC were enrolled in this study between February 2021 and January 2025, and all patients were randomly assigned to underwent TACE in 46 cases for control or lenvatinib maintenance treatment after TACE in another 46 cases for three months. The objective remission rate (ORR) and disease control rate (DCR) were evaluated. Serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), alpha fetoprotein (AFP), basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) levels were detected by ELISA. Results The ORR and DCR in combination group were 41.3% and 78.3%, both much higher than 21.7% and 54.3%(P<0.05) in the control; after treatment, serum CA19-9 and AFP levels in the combination group were (28.2±3.3)KU/L and (342.9±42.7)ng/mL, both much lower than [(40.2±4.6)KU/L and (427.9±46.9)ng/mL, respectively, P<0.05] in the control; serum bFGF, VEGF and HGF levels were (118.2±13.5)ng/L, (326.5±36.9)ng/L and (70.6±8.7)ng/mL, all much lower than [(138.9±15.2)ng/L, (427.5±46.2)ng/L and (92.7±10.6)ng/mL, respectively P<0.05] in the control group; during treatment, rash, capillary angiogenesis and proteinuria were found in some cases receiving lenvatinib treatment. Conclusion The lenvatinib maintenance treatment after TACE in the treatment of patients with aHCC is satisfactorily efficacious, which might accelerate tumor remission and inhibit tumor angiogenesis-related factor secretion.

Key words: Hepatocellular carcinoma, Advanced stage, Lenvatinib, Transarterial chemoembolization, Therapy

李杰, 季敏君, 刘晓艳, 王庆庆, 倪鑫. 经肝动脉灌注化疗栓塞术联合仑伐替尼治疗中晚期肝细胞癌患者临床疗效研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 289-292.

Li Jie, Ji Minjun, Liu Xiaoyan, et al. Clinical observation on lenvatinib maintenance therapy after transarterial chemoembolization in the treatment of patients with advanced hepatocellular carcinoma[J]. Journal of Practical Hepatology, 2026, 29(2): 289-292.

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经肝动脉灌注化疗栓塞术联合仑伐替尼治疗中晚期肝细胞癌患者临床疗效研究^*

Clinical observation on lenvatinib maintenance therapy after transarterial chemoembolization in the treatment of patients with advanced hepatocellular carcinoma

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