Clinical efficacy of different intervention regimens combined with Sintilimab and Lenvatinib in the treatment of advanced hepatocellular carcinoma
10.3760/cma.j.cn115396-20240320-00083
- VernacularTitle:不同介入方案联合信迪利单抗及仑伐替尼治疗中晚期肝癌的临床疗效
- Author:
Xiangyu ZHANG
1
;
Shasha PENG
Author Information
1. 黄石市中心医院介入科，黄石 435000
- Keywords:
Liver neoplasms;
Antineoplastic combined chemotherapy protocols;
Treatment outcome;
Hepatic artery infusion chemotherapy;
Sintilimab;
Lenvatinib
- From:
International Journal of Surgery
2024;51(4):253-259
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical efficacy of different intervention regimens combined with Sintilimab and Lenvatinib in the treatment of liver cancer.Methods:Using a case-control study method, a retrospective analysis was conducted on 72 patients with advanced liver cancer admitted to Huangshi Central Hospital from January 2020 to January 2023. They were divided into two groups according to the treatment plan. The TACE group (36 cases) received transcatheter hepatic artery embolization chemotherapy (TACE)+ Sintilimab+ Lenvatinib, while the HAIC group (36 cases) received hepatic artery infusion chemotherapy (HAIC)+ Sintilimab+ Lenvatinib. The research data and clinical efficacy of two groups were analyzed, liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil)], and tumor between the two groups. Markers [serum alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199)]and drug safety. Telephone and outpatient follow-up were conducted on patients after treatment, calculate the disease progression rate and mortality rate of two groups of patients, and follow up until the patient′s condition progresses or until March 1, 2024. Measurement data with normal distribution were expressed as mean±standard deviation ( ± s), t-test was used between the two groups. Chi-square test was used between the two groups of count data. Results:The objective response rate of TACE group was 27.78%, while that of HAIC group was 52.78%. The objective response rate of HAIC group was higher, and the difference between the two groups was statistically significant ( P<0.05); Before treatment, the levels of AST, ALT, and TBil in the two groups were compared, with P>0.05; After treatment, the AST of the TACE group was (36.65±4.80) U/L, ALT was (55.40±5.90) U/L, and TBil was (19.65±2.25) μmol/L, while the HAIC group was (25.95± 4.92) U/L, (41.15±6.15) U/L, and (14.40±2.13) μmol/L, respectively. The levels of various indicators in the HAIC group were lower, and the difference between the two groups was statistically significant ( P<0.05); Before treatment, there was no statistically significant difference in the levels of AFP, CEA, and CA199 between the two groups ( P>0.05); Before treatment, there was no statistically significant difference in the levels of alpha fetoprotein, carcinoembryonic antigen, and CA199 between the two groups ( P>0.05); After treatment, the levels of alpha fetoprotein, carcinoembryonic antigen, and CA199 in the TACE group were (152.50±20.10) ng/mL, (3.93±1.42) ng/mL, and (20.35±3.50) IU/mL, respectively, while those in the HAIC group were (102.35±18.10) ng/mL, (2.85±1.26) ng/mL, and (21.48±3.31) IU/mL, respectively. The levels of alpha fetoprotein and carcinoembryonic antigen in the HAIC group decreased more significantly ( P<0.05); The incidence of adverse reactions in the TACE group was 33.33%, while in the HAIC group it was 25.00%. There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P>0.05). All patients completed treatment. In the TACE group, there were 4 cases of disease progression and 1 case of death, with an incidence of adverse prognosis of 13.89%. In the HAIC group, there was 1 case of disease progression and no death, with an incidence of adverse prognosis of 2.78%. There was no statistical significance between the two groups( P=0.088). Conclusion:For liver cancer patients, the combination of HAIC+ Sintilimab+ Lenvatinib is more effective in improving liver function and tumor marker levels compared to the combination of HAIC+ Sintilimab+ Lenvatinib.
