摘要
目的探讨肝动脉灌注化疗联合程序性死亡受体1(PD-1)抗体及仑伐替尼治疗晚期肝癌合并门静脉癌栓的临床效果及安全性。方法回顾性分析2020年12月至2023年5月萍乡市人民医院收治的21例接受肝动脉灌注化疗联合PD-1抗体及仑伐替尼的合并门静脉癌栓晚期肝癌患者资料。所有患者均进行肝动脉灌注化疗、免疫及靶向治疗。分析患者的总生存期、无进展生存期、总缓解率及疾病控制率,记录治疗及随访期间的不良事件。结果治疗后,0例完全缓解,7例部分缓解,11例疾病稳定,3例疾病进展。其中总缓解率为38.45%,疾病控制率为85.71%。甲胎蛋白(AFP)中位水平为184.07(9.44,7103.85)ng/ml,治疗前AFP中位水平为553.28(50.43,11542.05)ng/ml,治疗后低于治疗前,差异有统计学意义(P<0.05);患者中位随访时间为12.71个月(4~24)个月,总生存期6个月为89.2%,总生存期12个月为63.1%,中位总生存期并未达到;无进展生存期6个月为70.38%,中位无进展生存期为9.48个月(95%CI:7.26~11.72);常见的1~2级不良事件有高血压、乏力、谷丙转氨酶升高等,其中3级不良事件有16例,通过对症治疗,均在下一周期治疗前康复。结论肝动脉灌注化疗联合PD-1抗体及仑伐替尼治疗晚期肝癌合并门静脉癌栓的肿瘤反应性良好,治疗过程出现的不良反应也是可控的。
Objective To investigate the clinical efficacy and safety of hepatic arterial infusion chemotherapy combined with programmed death receptor 1(PD-1)antibody and lenvastinib in the treatment of advanced liver cancer complicated with portal vein cancer thrombus.Methods A retrospective analysis was performed on 21 patients with advanced liver cancer with portal vein thrombus who received hepatic arterial infusion chemotherapy combined with PD-1 antibody and Renvastinib in Pingxiang People's Hospital from December 2020 to May 2023.All patients received hepatic arterial infusion chemotherapy,immunization and targeted therapy.Overall survival,progression-free survival,overall response rate and disease control rate were counted.Adverse events during treatment and follow-up were recorded.Results After treatment,0 cases had complete response,7 cases had partial response,11 cases had stable disease,and 3 cases had progressive disease.The overall response rate was 38.45%,and the disease control rate was 85.71%.The median alpha-fetoprotein(AFP)level was 184.07(9.44,7103.85)ng/ml,and the median AFP level before treatment was 553.28(50.43,11542.05)ng/ml,which was lower after treatment than before treatment,and the difference was statistically significant(P<0.05).The median follow-up time was 12.71 months(4-24)months.The overall survival time was 89.2%at 6 months and 63.1%at 12 months.The median overall survival time was not reached.The 6-month progression-free survival was 70.38%,and the median progression-free survival was 9.48 months(95%CI:7.26-11.72).The common grade 1 to 2 adverse events were hypertension,fatigue,and elevated glutamic-pyruenic aminotransferase,among which 16 cases of grade 3 adverse events were recovered by symptomatic treatment before the next cycle of treatment.Conclusion Hepatic artery infusion chemotherapy combined with PD-1 antibody and Renvastinib in the treatment of advanced liver cancer with portal vein cancer thrombus has good tumor responsiveness,and the adverse reactions in the treatment process
作者
李洁
李瑞娟
鲁志兵
曾筱怡
LI Jie;LI Ruijuan;LU Zhibing;ZENG Xiaoyi(Department of Oncology,Pingxiang People's Hospital,Jiangxi Province,Pingxiang337000,China;Department of Oncology,the Second Pingxiang People's Hospital,Jiangxi Province,Pingxiang337000,China)
出处
《中国当代医药》
CAS
2024年第26期43-46,51,共5页
China Modern Medicine
基金
江西省卫生健康委员会科技计划项目(202140464)。
关键词
肝动脉灌注化疗
程序性死亡受体1抗体
仑伐替尼
晚期肝癌
门静脉癌栓
Hepatic arterial infusion chemotherapy
Programmed death receptor 1 antibody
Renvastinib
Advanced liver cancer
Portal vein cancer thrombus
