肝动脉化疗栓塞联合射频消融和免疫靶向治疗术后复发的肝细胞癌患者近远期疗效研究*

doi:10.3969/j.issn.1672-5069.2022.05.027

Abstract

Abstract: Objective The purpose of this study was to explore the short-term efficacy of transcatheter arterial chemoembolization (TACE), radiofrequency ablation (RFA) and immune targeted therapy combination in the treatment of patients with postoperative recurrent hepatocellular carcinoma (HCC). Methods A total of 150 patients with postoperative recurrent HCC were enrolled in our hospital between August 2014 and April 2018, and were divided randomly into control and obserbation group, with 75 cases in each group. The patients in the control group underwent TACE and RFA, while those in the observation group were treated with anti-programmed cell death protein 1 (PD-1) and angiogenesis inhibitors, apatinib, combination on the basis in control group. The clinical efficacy was evaluated by solid tumor mRESIST standards. The peripheral blood T cell subsets were detected by flow cytometry. The survival in the two groups after surgery was analyzed by Kaplan-Meier method. Results At the end of three months after treatment, the total response rate in the observation group was significantly higher than that in the control group (81.3% vs. 53.3%, P<0.05); the percentages of peripheral blood CD3⁺ and CD4⁺ cells and CD4⁺/CD8⁺ cell ratio were (68.2±6.8)%, (45.9±4.7)% and (1.8±0.3), significantly higher than [(56.5±6.1)%, (33.3±4.5)% and (1.3±0.2), respectively, P<0.05], while the percentage of CD8⁺ cells was (22.5±1.8)%, significantly lower than [(28.3±1.4)%, P<0.05] in the control; the incidence of untoward effects grade I/II in the observation group was 73.3%, significantly higher than 32.0%(P<0.05) in the control; the 1-year survival in the observation group was 49.3%, significantly higher than 30.7%(P<0.05) in the control. Conclusion The combination of TACE, RFA and immune targeted therapy could effectively improve short-term clinical efficacy in patients with postoperative recurrent HCC, which might be related to the up-regulation of cellular immune functions.

Key words: Hepatoma, Transcatheter arterial chemoembolization, Radiofrequency ablation, Targeted therapy

Li Qinghan, Zhen Zuojun, He Yintao. Short-term efficacy of TACE, RFA, anti-PD-1 antibody and apatinib combination in the treatment of patients with postoperative recurrent hepatocellular carcinoma[J]. Journal of Practical Hepatology, 2022, 25(5): 714-717.

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Short-term efficacy of TACE, RFA, anti-PD-1 antibody and apatinib combination in the treatment of patients with postoperative recurrent hepatocellular carcinoma

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