TACE、靶向免疫联合125I粒子植入在不可切除巨块型肝癌患者中的应用效果

摘要/Abstract

摘要： 目的评估TACE、靶向免疫联合¹²⁵I粒子植入在不可切除巨块型肝癌患者中的应用效果。方法回顾性收集空军军医大学第二附属医院2020年12月至2024年1月期间收治的88例不可切除巨块型肝癌患者,将接受TACE联合靶向免疫治疗的43例设为对照组,45例接受TACE+靶向免疫+¹²⁵I粒子植治疗的患者设为观察组,均治疗4个疗程。两组均未发生血管侵犯以及肝外转移,且基线资料差异无统计学意义(P>0.05),有可比性。比较两组患者的治疗4个疗程后的临床疗效、免疫功能、肿瘤标志物水平[甲胎蛋白(AFP)、异常凝血酶原(PIVKA-Ⅱ)]、总生存期(OS)及不良反应。结果与对照组相比,观察组疗效提高(86.67%比62.79%,P<0.05)。治疗后观察组AFP和PIVKA-Ⅱ分别为(63.05±7.51)ng/mL和(113.25±11.01)mAU/mL,对照组分别为(80.84±9.42)ng/mL和(150.64±16.13)mAU/mL(P<0.05)。对照组中出现腹痛3例、恶心呕吐2例、乏力3例、免疫相关皮肤反应5例、肝功能异常2例;观察组中出现腹痛2例、恶心呕吐2例、乏力4例、免疫相关皮肤反应4例、肝功能异常3例、放射性损伤1例。两组治疗3个月后病灶最大截面积皆缩小,观察组和对照组平均OS为21.43(20.34,22.59)和18.41(16.98,19.76)个月(P<0.05)。结论 TACE+靶向免疫+¹²⁵I粒子植入有助于改善不可切除巨块型肝癌患者免疫功能,提高治疗效果。

关键词: 不可切除巨块型肝癌, 经动脉化疗栓塞, ¹²⁵I粒子植入, 靶向免疫, 疗效

Abstract: Objective To evaluate the efficacy of transcatheter arterial chemoembolization (TACE), targeted immunotherapy combined with ¹²⁵I particle implantation in patients with unresectable giant hepatocellular carcinoma (HCC). Methods A retrospective analysis was conducted on 88 patients with unresectable giant HCC who were treated at Second Affiliated Hospital of Air Force Medical University from December 2020 to January 2024. The patients were divided into two groups based on the treatment modality: a TACE combined with targeted immunotherapy group (control group, 43 cases), and a TACE+targeted immunotherapy+¹²⁵I particle implantation group (observation group, 45 cases), with all patients receiving four treatment cycles. Both groups showed no vascular invasion or extrahepatic metastasis at baseline, and there were no significant differences in baseline data (P>0.05), and ensuring comparability. The clinical efficacy, immune function, tumor marker levels (AFP, PIVKA-Ⅱ), progression-free survival (PFS), and adverse reactions between these two groups were compared after four cycles of treatment. Results The efficacy of treatment in the observation group was significantly higher than that in the control group (86.67% vs. 62.79%) (P<0.05). After treatment, the levels of AFP and PIVKA-Ⅱ in the observation group were (63.05±7.51) ng/mL and (113.25±11.01) mAU/mL, respectively, while in the control group, they were (80.84 ± 9.42) ng/mL and (150.64±16.13) mAU/mL (P<0.05). Three months post-treatment, the maximum lesion cross-sectional area had decreased in both groups. The average overall survival (OS) in the observation and control groups was 21.43 (20.34, 22.59) months and 18.41 (16.98, 19.76) months, respectively (P<0.05). Conclusion TACE combined with targeted immunotherapy and ¹²⁵I particle implantation can improve immune function and enhance treatment efficacy in patients with unresectable giant HCC.

Key words: Unresectable massive liver cancer, Transcatheter arterial chemoembolization, ¹²⁵I particle implantation, Targeted immunity, Curative effect

沈祥京, 苏海川. TACE、靶向免疫联合¹²⁵I粒子植入在不可切除巨块型肝癌患者中的应用效果[J]. 肝脏, 2025, 30(4): 458-461.

SHEN Xiang-jing, SU Hai-chuan. The application of TACE, targeted immunotherapy combined with ¹²⁵I particle implantation in patients with unresectable giant hepatocellular carcinoma[J]. Chinese Hepatolgy, 2025, 30(4): 458-461.

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TACE、靶向免疫联合¹²⁵I粒子植入在不可切除巨块型肝癌患者中的应用效果

The application of TACE, targeted immunotherapy combined with ¹²⁵I particle implantation in patients with unresectable giant hepatocellular carcinoma

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