TACE联合贝伐单抗HAIC对肝细胞癌患者疗效的影响

摘要/Abstract

摘要： 目的评估肝动脉化疗栓塞术(transarterial chemoembolization,TACE)与贝伐单抗肝动脉灌注治疗(hepatic arterial infusion chemotherapy,HAIC)联合应用在肝细胞癌患者中的疗效,探讨其对患者术后生存质量、肿瘤标志物水平以及远期和近期生存率的影响。方法本研究前瞻性选取2019年5月至2022年5月在黑龙江中医药大学附属第一医院进行治疗的131例肝细胞癌患者,根据治疗方法分为TACE组(47例)与联合组(84例)。TACE组接受TACE治疗,联合组接受TACE治疗前使用贝伐单抗肝动脉灌注治疗。比较疗效及临床收益率。检测并比较血清肿瘤标志物水平。检测并比较两组患者术前及术后3个月肿瘤相关蛋白因子水平。评估两组生存质量卡式(KPS)评分。进行随访并绘制生存曲线。结果治疗后联合组血清AFP、VEGF、CA125、CEA、CYFRA21-1、SCC、CA50水平均低于TACE组(P<0.05)。治疗后联合组PTEN相对表达量高于TACE组;联合组MUCI相对表达量、HSP90α水平分别为(1.72±0.22)、(45.31±2.94) ng/mL,均低于TACE组(P<0.05)。治疗后联合组KPS评分高于TACE组(P<0.05)。随访过程中,TACE组患者存活35例,联合组患者存活79例。联合组两年OS的累计生存率高于TACE组(χ²=22.734,P<0.05)。联合组两年PFS累计生存率高于TACE组(χ²=23.428,P<0.05)。结论 TACE联合贝伐单抗HAIC可显著提升肝细胞癌患者的近期及远期预后。该治疗方案通过协同作用机制有效降低血清甲胎蛋白等肿瘤标志物浓度,同时改善患者KPS评分。这一综合治疗模式在提高总体生存期和无进展生存期方面具有显著优势,为肝癌治疗提供了新的临床路径。

关键词: 肝细胞癌, 肝动脉化疗栓塞术, 贝伐单抗, 肝动脉灌注治疗, 生存分析

Abstract: Objective To evaluate the efficacy of transarterial chemoembolization (TACE) combined with bevacizumab hepatic arterial infusion chemotherapy (HAIC) in patients with primary hepatocellular carcinoma (HCC), and to explore its effects on postoperative quality of life, tumor marker levels, as well as short- and long-term survival rates. Methods This prospective study enrolled 131 HCC patients treated at the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from May 2019 to May 2022. Patients were divided into two groups: the TACE group (n=47) receiving TACE alone, and the combination group (n=84) receiving TACE preceded by bevacizumab HAIC. Efficacy and clinical benefit rates were compared between the two groups. Serum tumor marker levels were measured pre- and post-treatment. Tumor-related protein factors were analyzed before and 3 months after treatment. Quality of life was assessed using the Karnofsky Performance Status (KPS) score. Survival curves were generated during follow-up. Results Post-treatment serum levels of AFP, VEGF, CA125, CEA, CYFRA21-1, SCC, and CA50 in the combination group were significantly lower than those in the TACE group (P<0.05). The combination group showed higher PTEN expression and lower MUC1 expression (1.72±0.22 vs. TACE group) and HSP90α levels (45.31±2.94 ng/mL vs. TACE group, P<0.05). The combination group achieved higher KPS scores post-treatment (P<0.05). During follow-up, 79 patients survived in the combination group versus 35 in the TACE group. The combination group demonstrated significantly higher cumulative 2-year overall survival (OS: χ²=22.734, P<0.05) and progression-free survival (PFS: χ²=23.428, P<0.05) rates. Conclusion TACE combined with anti-VEGF monoclonal antibody (bevacizumab) HAIC significantly improves both short- and long-term prognoses in HCC patients. This synergistic regimen effectively reduces serum tumor markers such as AFP and enhances functional status (KPS), demonstrating superior survival benefits in OS and PFS. The combined modality represents a promising clinical strategy for HCC management.

Key words: Primary liver cancer, Transarterial chemoembolization, Bevacizumab, Hepatic arterial infusion chemotherapy, Survival analysis

韩啸, 刘松江, 秦帅. TACE联合贝伐单抗HAIC对肝细胞癌患者疗效的影响[J]. 肝脏, 2025, 30(4): 480-484.

HAN Xiao, LIU Song-jiang, QIN Shuai. Efficacy of TACE combined with bevacizumab-based HAIC in patients with hepatocellular carcinoma[J]. Chinese Hepatolgy, 2025, 30(4): 480-484.

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