Abstract: Objective To evaluate the effects of TACE combined with lenvatinib or combined with apatinib in treating advanced primary liver cancer (PLC). Methods Eighty-five patients (2022.01-2023.12) with middle- to late-stage PLC admitted to the Affiliated Cancer Hospital of Nantong University were selected and divided into two groups according to their treatment regimens. Forty-two patients in the control group received TACE combined with apatinib, while forty-three patients in the observation group were treated with TACE combined with lenvatinib. Results TheObjective remission rate (ORR 60.47%) and disease control rate (DCR 74.42%) in the observation group were significantly better than those in the control group (ORR 35.71%; DCR 52.38%) (P<0.05). After treatment, the level of tumor markers [CEA(13.36±2.47)ng/mL vs. (19.63±3.14)ng/mL,CA125(52.63±6.89)U/mL vs.(58.49±8.69)U/mL,VEGF(292.69±23.46)ng/mL vs. (341.63±28.48)ng/mL], liver function [TBil(16.85±3.89)μmol/L vs. (21.78±4.02)μmol/L,ALT(42.63±6.52)U/L vs. (53.69±7.25)U/L,VEGF(38.52±4.69)U/L vs. (48.20±5.06)U/L]and immune function[CD4⁺(46.32±4.87)% vs. (42.69±4.38)%,CD8⁺(22.36±3.25)% vs. (26.82±3.84)%,CD4⁺/CD8⁺ ratio(1.95±0.28) vs. (1.54±0.25)] in the observation group were better than those in the control group (P<0.05). Comparing the adverse events of the two groups, the differences were not statistically significant (P>0.05). Conclusion TACE combined with lenvatinib showed better clinical outcomes, improved tumor and immune markers, and enhanced liver function compared to TACE combined with Apatinib in patients with advanced PLC, with no significant difference in adverse reactions.

Key words: Transarterial chemoembolization, Lenvatinib, Apatinib, Intermediate and advanced primary liver cancer