[1]黄树圭,魏启明,张锋涛.经肝动脉灌注化疗联合阿帕替尼及卡瑞利珠单抗治疗合并门静脉主干癌栓肝细胞癌安全性和有效性分析[J].介入放射学杂志,2025,34(09):1002-1009.[doi:10.3969/j.issn.1008-794X.2025.09.017]
　HUANG Shugui,WEI Qiming,ZHANG Fengtao..Hepatic arterial infusion chemotherapy combined with apatinib and carizolizumab for hepatocellular carcinoma with major portal vein tumor thrombosis:analysis of its safety and efficacy[J].J Intervent Med,2025,34(09):1002-1009.[doi:10.3969/j.issn.1008-794X.2025.09.017]
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经肝动脉灌注化疗联合阿帕替尼及卡瑞利珠单抗治疗合并门静脉主干癌栓肝细胞癌安全性和有效性分析()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
34
期数:
2025年09
页码:
1002-1009
栏目:
临床研究
出版日期:
2025-09-25

文章信息/Info

Title:
Hepatic arterial infusion chemotherapy combined with apatinib and carizolizumab for hepatocellular carcinoma with major portal vein tumor thrombosis:analysis of its safety and efficacy
文章编号:
1008-794X(2025)-009-1002-08
作者:
黄树圭;  魏启明;  张锋涛
510080 广东广州 广东药科大学附属第一医院普外一科(黄树圭); 广东省中医院介入科(魏启明); 华中科技大学协和深圳医院(深圳市南山区人民医院)介入科(张锋涛)
Author(s):
HUANG Shugui1; WEI Qiming2; ZHANG Fengtao3.
1Section I,Department of General Surgery,First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou,Guangdong Province 510080,China; 2Department of Interventional Therapy,Guangdong Provincial Hospital of Traditional C
关键词:
经肝动脉灌注化疗;  阿帕替尼;  卡瑞利珠单抗;  肝细胞癌;  门静脉主干癌栓;  倾向性评分匹配
分类号:
R735.7
DOI:
10.3969/j.issn.1008-794X.2025.09.017
文献标志码:
B
摘要:
目的 探究经肝动脉灌注化疗(HAIC)联合阿帕替尼及卡瑞利珠单抗治疗合并门静脉主干癌栓(Vp4)肝细胞癌(HCC)的安全性和有效性。方法 回顾性收集自2018年7月至2023年12月间来自3个三级医疗中心接受HAIC联合阿帕替尼及卡瑞利珠单抗三联治疗或单纯HAIC治疗合并Vp4HCC患者的临床资料。使用倾向性评分匹配(PSM)平衡组间一般情况差异,比较PSM前后三联治疗组和单纯HAIC治疗组间总生存时间(OS)、无进展生存时间(PFS)和肿瘤应答率。基于COX比例风险回归模型明确生存相关危险因素。安全性方面,对比不同治疗方案组间不良反应发生率差异。结果 整体队列中,HAIC联合阿帕替尼及卡瑞利珠单抗三联治疗合并Vp4的HCC患者中位OS和中位PFS分别为16.4个月和9.1个月。单纯HAIC治疗组中位OS和中位PFS分别为6.9个月和4.2个月(均P<0.001)。肿瘤应答方面,三联治疗组和单纯HAIC治疗组客观缓解率(ORR)分别为41.2%和15.2%(P<0.001),而疾病控制率(DCR)分别为77.9%和68.5%(P=0.185)。PSM队列中,相较于单纯HAIC治疗组中位OS和中位PFS的7.4个月和3.7个月,三联治疗组中位OS和中位PFS分别为16.4个月和9.1个月,较前者显著延长。在肿瘤应答上,三联治疗组和单纯HAIC治疗组ORR分别为39.5%和11.6%(P=0.003),而DCR分别为81.4%和62.8%(P=0.054)。单因素和多因素分析显示,接受HAIC联合阿帕替尼及卡瑞利珠单抗治疗是OS和PFS共同的独立影响因素。安全性方面,尽管部分三联治疗组不良反应发生率高于单纯HAIC治疗组,组间各级不良反应发生率差异均无统计学。结论 相较于单纯HAIC治疗,HAIC联合阿帕替尼及卡瑞利珠单抗具有更优的生存获益以及肿瘤应答率,且安全性可耐受,是一种有希望的治疗手段。

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(收稿日期:2024-08-08)

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备注/Memo

备注/Memo:
通信作者: 张锋涛 E-mail:191157980@qq.com
更新日期/Last Update: 2025-09-25