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