Abstract: Objective To evaluate the clinical efficacy of capecitabine peritoneal arterial perfusion chemotherapy combined with cindilimab and bevacizumab injection in patients with unresectable hepatic cancer.Methods Between April 2017 and October 2023, 81 patients with unresectable liver cancer admitted to our hospital were included in this study. Using a random number table method, patients were divided into an EPI group (n=40, receiving pirarubicin intraperitoneal arterial perfusion chemotherapy) and a trial group (n=41, receiving additional sintilimab and bevacizumab injection on basis of the EPI treatment). The clinical outcomes, changes of tumor markers in liver cancer, liver function, quality of life, and adverse events were compared between the two groups.Results After four weeks of treatment, the Objective response rate (ORR) in the trial group was found to be higher than that in the EPI group (P<0.05). After treatment, the levels of alpha-fetoprotein (AFP), vascular endothelial growth factor (VEGF), and β-catenin in the trial group were (185.21±42.87) ng/mL, (126.12±30.94) pg/mL, and (267.45±41.77) pg/L, respectively, all of which were lower than those in the EPI group [(234.19±60.12) ng/mL, (173.09±44.03) pg/mL, (398.72±52.83) pg/L, P<0.05]. Similarly, the levels of ALT [(62.18±6.94) U/L] and AST [ (34.09±2.71) U/L] in the trial group were lower than those in the EPI group [(94.89±8.78) U/L, (66.34±3.91) U/L, P<0.05]. Conversely, the level of total bilirubin (TBIL) was higher in the trial group [(33.64±4.03) μmol/L], compared to (27.42±2.97) μmol/L in the EPI group (P<0.05). Additionally, the Karnofsky performance status (KPS) scores at two weeks (68.18±2.94) and three months (62.45±2.93) after treatment were higher in the trial group, compared to (63.76±2.71) and (62.45±2.93) in the EPI group (P<0.05).Conclusion Capecitabine peritoneal arterial perfusion chemotherapy combined with cindilimab and bevacizumab injection significantly can enhance the quality of life and immune function of patients with unresectable hepatic cancer, and reduce tumor marker levels, which is safe for clinical use and is supported for a broader clinical application.

Key words: Unresectable hepatic cancer, Capecitabine, Cindilimab, Bevacizumab, Quality of life