Abstract: Objective To analyze the efficacy of transarterial chemoembolization (TACE) and TACE combined with lenvatinib mesylate in the treatment of advanced primary liver cancer (PLC) and its impact on safety. Methods A total of 125 patients with advanced PLC admitted to Baoji Central Hospital (February 2020-April 2024) were selected and divided into two groups according to the treatment methods. 61 cases in the control group were treated with TACE, and 64 cases in the observation group were treated with lenvatinib mesylate in addition. The therapeutic effects of the two groups were compared. Results The DCR rate of the observation group was 84.38% (54/64), and the ORR rate was 62.50% (40/64), which were 65.57% (40/61) /31.15% (19/61) higher than those of the control group (χ² values=5.920, 12.319; all P values＜0.05). Three weeks of treatment The AST level (35.62±6.14) U/L, ALT level (62.01±4.28) U/L, and TBil level (20.02±3.47) μmol/L in the observation group were lower than those in the control group [43.52±7.63) U/L, (67.17±5.32) U/L, (21.82±3.08) μmol/L] (P<0.05). After 3 weeks of treatment, the levels of CD3⁺ (66.22±8.19)/μL and CD4⁺ (33.69±3.74)/μL in the observation group were higher than those in the control group (62.04±7.60)/μL and (30.05±3.47)/μL, while the level of CD8⁺ (26.23±2.84)/μL was lower than that in the control group (29.96±3.17)/μL (P<0.05). After 3 weeks of treatment, the AFP level (79.62±6.47) ng/mL and CEA level (13.66±2.34) U/mL in the observation group were lower than those in the control group [(150.39±10.46) ng/mL and (14.85±2.47) U/mL]. The level of CA199 (31.04±5.07) ng/mL was higher than that of the control group (28.03±4.92) ng/mL (P<0.05). The incidence of fever in the observation group was 3.13% (2/64), which was lower than 13.11% (8/61) in the control group (χ² value=4.235, P value=0.040). Patients were followed up for one year. The survival rate of the observation group was 92.19% (59/64), which was higher than that of the control group at 83.61% (51/61). χ²=0.285, P=0.594. Conclusion The treatment of advanced PLC patients with TACE combined with lenvatinib mesylate has a significant effect. It can significantly improve immune function and liver function, effectively reduce tumor markers, and has a low mortality rate.

Key words: Transarterial chemoembolization, Lenvatinib mesylate, Middle and late stages, Primary liver cancer