摘要
目的评价微波消融术(MWA)应用于载药微球经肝动脉化疗栓塞术(DEB-TACE)联合靶向及免疫治疗进展期肝细胞癌(HCC)的有效性与安全性。方法回顾性分析2019-01-01-2021-01-01山东第一医科大学第一附属医院经病理活检诊断(79例)或临床诊断(32例)为进展期HCC的111例患者临床资料。按是否行MWA治疗分为MWA组(46例)和非MWA组(65例)。截止随访,所有患者接受≥2个月的阿帕替尼及卡瑞利珠单抗联合治疗。采用log-rank检验比较2组无进展生存期(PFS)和2年总生存(OS)率差异。结果2组患者在阿帕替尼治疗周期(Z=2.350,P=0.021)、卡瑞利珠单抗治疗周期(Z=2.120,P=0.030)和DEB-TACE治疗次数(Z=-4.640,P<0.001)差异均有统计学意义。MWA组和非MWA组的PFS为13.90(95%CI:9.63~19.88)和5.13(95%CI:4.73~6.41)个月,差异有统计学意义,Z=21.191,P<0.001。MWA组疾病进展风险降低75.71%(HR=0.243,95%CI:0.121~0.491)。MWA组与非MWA组2年OS率分别为87.25%(95%CI:0.719~0.945)和50.57%(95%CI:0.337~0.653),差异有统计学意义,χ2=5.714,P<0.001。2组均无治疗相关死亡,主要并发症发生率相似,差异均无统计学意义。结论与非MWA组的治疗模式相比,MWA组的治疗模式延长了进展期HCC患者的PFS,降低疾病进展风险,提高了2年OS率,具有更好的疗效和相似的安全性。
Objective To evaluate the efficacy and safety of microwave ablation(MWA)used in drug-eluting beads transarterial chemoembolization(DEB-TACE)combined with targeted therapy and immunotherpy in the treatment of advanced primary hepatic carcinoma(HCC).Method The clinical data of 111 patients with advanced HCC diagnosed by pathological biopsy(79 cases)and clinical diagnosis(32 cases)from the First Affiliated Hospital of Shandong First Medical University from January 1,2019 to January 1,2021 were retrospectively analyzed.The patients were divided into MWA group and non-MWA group based on whether they underwent MWA treatment or not.As of follow up,all patients underwent Apatinib and Carrilizumab for at least 2 months.Progression-free survival(PFS)and 2-year overall survival(OS)were compared between the two groups by log-rank test.Results There were statistically significant of Apatinib treatment cycles(Z=2.350,P=0.021),carrellizumab treatment cycles(Z=2.120,P=0.030)and DEB-TACE treatment cycles(Z=-4.640,P<0.001)between the two groups.The PFS of the MWA and non-MWA groups was 13.90 months(95%CI:9.63-19.88)and 5.13 months(95%CI:4.73-6.41),and the difference was statistically significant(Z=21.191,P<0.001).Patients in MWA group had a 75.71% lower risk of disease progression(HR=0.243,95%CI:0.121-0.491).The 2-year OS rates were 87.25%(95%CI:0.719-0.945)and 50.57%(95%CI:0.337-0.653)in MWA group and non-MWA group,respectively.There were no treatment-related mortalities in either group.The incidence of major complications of two groups was similar.Conclusions Compared with non-MWA group,the treatment mode of the MWA group prolongs the PFS of advanced HCC patients,reduces the risk of disease progression,increases the 2-year OS rate,and has better efficacy and similar safety.
作者
王楠
薛国亮
徐静雯
危志刚
叶欣
WANG Nan;XUE Guoliang;XU Jingwen;WEI Zhigang;YE Xin(Shandong Provincial Qianfoshan Hospital,the First Affiliated Hospital of Shandong First Medical University,Jinan 250014,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2023年第14期865-870,共6页
Chinese Journal of Cancer Prevention and Treatment
基金
中国博士后科学基金(2022M711979)。
关键词
原发性肝癌
载药微球
经肝动脉化疗栓塞术
微波消融
免疫治疗
primary hepatocellular carcinoma
callispheres drug-loaded microsphere
transarterial chemoembolization
microwave ablation
immunotherapy
作者简介
第一作者:王楠,男,山东潍坊人,硕士,主治医师,主要从事肿瘤微创治疗方面的研究工作。E-mail:drwangnan@126.com;通信作者:叶欣,男,山东泰安人,主任医师,博士生导师,从事肿瘤微创治疗方面的研究工作。E-mail:yexintaian2020@163.com
