摘要
目的探讨肝动脉化疗栓塞(TACE)联合抗血管生成药(TKI)及程序性死亡受体1(PD-1)单抗综合治疗进展期肝癌的临床疗效及安全性。方法纳入2019年9月至2021年9月西南医科大学附属医院收治的108例进展期肝癌患者,按治疗方式差异分为TACE+TKI组(n=60)及TACE+TKI+PD-1单抗组(n=48)。回顾性收集两组患者的临床资料,用倾向评分匹配(PSM)控制基线特征,分析PSM后两组患者临床疗效、生存情况,并对两组不良反应发生情况作统计分析。结果PSM后两组患者临床疗效比较,差异无统计学意义(P>0.05)。截止至2023年3月,TACE+TKI+PD-1单抗组PSM后中位无进展生存期(PFS)、总生存期(OS)分别为9.6个月、17.0个月,长于TACE+TKI组(6.4个月、10.8个月),差异均有统计学意义(P<0.05)。两组PSM后Ⅰ+Ⅱ级、Ⅲ+Ⅳ级不良反应发生率比较,差异均无统计学意义(P>0.05)。结论进展期肝癌患者应用TACE联合TKI或是TACE联合TKI及PD-1单抗均可获得较佳临床疗效,但后者可延长患者生存期,且不提高不良反应发生率。
Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoembolization(TACE)combined with antiangiogenic drugs(TKI)and programmed death 1(PD-1)monoclonal antibody in the treatment of advanced liver cancer.Methods A total of 108 patients with advanced liver cancer admitted to the Affiliated Hospital of Southwest Medical University from September 2019 to September 2021 were included and divided into TACE+TKI group(n=60)and TACE+TKI+PD-1 mab group(n=48)according to different treatment methods.Clinical data of the two groups were collected and baseline characteristics were controlled according to propensity score matching(PSM).The clinical efficacy and survival of the patients in the two groups after PSM were analyzed,and the occurrences of adverse reactions of the two groups were statistically analyzed.Results There was no statistically significant difference in clinical efficacy between the two groups before and after PSM(P>0.05).By March 2023,the median progression-free survival(PFS)and overall survival(OS)of PSM in TACE+TKI+PD-1 monoclonal antibody group were 9.6 months and 17.0 months,which were higher than(6.4 months and 10.8 months)in TACE+TKI group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of grade Ⅰ+Ⅱ and grade Ⅲ+Ⅳ adverse events after PSM between 2 groups(P>0.05).Conclusion TACE combined with TKI or TACE combined with TKI and PD-1 antibody can achieve better clinical efficacy in patients with advanced liver cancer,but the latter can prolong the survival of patients without increasing the incidence of adverse events.
作者
李琪
颜敏
苏珂
韩云炜
何坤
范娟
LI Qi;YAN Min;SU Ke(Department of Oncology,The Affiliated Hospital of Southwest Medical University,Luzhou Sichuan 646000,China)
出处
《临床和实验医学杂志》
2023年第17期1813-1817,共5页
Journal of Clinical and Experimental Medicine
基金
北京白求恩公益基金资助项目(编号:HR20012)。
关键词
癌
肝细胞
肝动脉化疗栓塞
抗血管生成药
程序性死亡受体1单抗
Carcinoma,hepatocelluar
Hepatic arterial chemoembolization
Antiangiogenic agents
Programmed death receptor 1 monoclonal antibody
