[A retrospective controlled study of TACE-HAIC-targeted-immune quadruple therapy for intermediate and advanced-stage hepatocellular carcinoma].

医学 肝细胞癌 内科学 胃肠病学 阶段(地层学) 比例危险模型 联合疗法 对数秩检验 不利影响 肿瘤科 生存分析 入射(几何) 生物 光学 物理 古生物学
作者
L Li,Jiao He,Yuping Xie,X H Huang,Xiadi Weng,Xinting Pan,Yubin Jiao,Hou-bing Zheng,Luzhen Qiu,Wanping Guo
出处
期刊:PubMed 卷期号:30 (9): 939-946
标识
DOI:10.3760/cma.j.cn501113-20220823-00432
摘要

Objective: To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE)-hepatic arterial infusion chemotherapy (HAIC)-targeted-immune quadruple therapy in patients with intermediate and advanced-stage hepatocellular carcinoma (HCC). Methods: 101 patients with intermediate and advanced stage HCC were enrolled according to the inclusion and exclusion criteria, and then they were divided into a combination group and a control group. Patients in the combination group was treated with TACE-HAIC-targeted-immune quadruple therapy, while the control group was only treated with TACE therapy. The overall survival (OS), progression-free survival (PFS), and treatment-related adverse reactions were statistically analyzed in the two groups of patients. Statistical analysis was carried out by t-test, χ2 test, rank sum test, Kaplan-Meier curve, log-rank test, Cox regression (or proportional hazards model) analysis according to different data. Results: The tumor objective response rate and disease control rate as evaluated by mRECIST 1.1 criteria in the combination group were 80% and 94%, respectively, which were significantly higher than those in the control group, 41.2% (P<0.001) and 74.5% (P=0.007). The OS and PFS of the combination group were 15.6 months [95%CI 11.3-NA ] and 8.8 months [95%CI 6.9-12.0], respectively, which were significantly better than the control group at 6.1 months [95%CI 5.3-6.6] (P<0.001) and 3.2 months [95%CI 3.0-3.6] (P<0.001). Gastric ulcer incidence was significantly higher in the combination group (9/50, 18%) than that in the control group (2/51, 3.9%) (P=0.023). Conclusion TACE-HAIC-targeted-immune quadruple therapy is a more effective treatment mode for intermediate and advanced-stage HCC than TACE alone, and attention should be paid to the monitoring of target immune-related adverse reactions.目的: 评价经导管动脉化疗栓塞术(TACE)-肝动脉灌注化疗(HAIC)-靶向-免疫四联治疗中晚期肝细胞癌(HCC)患者的疗效和安全性。 方法: 根据入排标准入组101例中晚期HCC患者,分为联合组和对照组。联合组患者行TACE-HAIC-靶向-免疫四联治疗,对照组患者仅接受TACE治疗。对2组患者的总生存期(OS)、无疾病进展生存期(PFS)、治疗相关的不良反应进行统计分析。据资料不同采用t检验、χ2检验、秩和检验、Kaplan-Meier曲线、对数秩检验、Cox回归分析或Cox比例风险模型分析进行统计学分析。 结果: 以mRECIST 1.1标准评估联合组肿瘤客观缓解率和疾病控制率分别为80%和94%,明显高于对照组的41.2%(P<0.001)和74.5%(P=0.007)。联合组的OS和PFS为15.6(95%CI 11.3~NA)个月和8.8(95%CI 6.9~12.0)个月,明显优于对照组的6.1(95%CI 5.3~6.6)个月(P<0.001)和3.2(95%CI 3.0~3.6)个月(P<0.001)。联合组胃溃疡发生率(9/50,18%)比对照组(2/51,3.9%)明显增加(P=0.023)。 结论: TACE-HAIC-靶向-免疫四联治疗对比单纯TACE治疗是一种更有效的中晚期HCC治疗方式,需注意对靶免治疗相关不良反应的监测。.
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