Lenvatinib combined with drug-eluting bead transarterial chemoembolization and hepatic arterial infusion chemotherapy for hepatocellular carcinoma larger than 7 cm with portal vein tumor thrombosis
10.3760/cma.j.cn113855-20250214-00084
- VernacularTitle:仑伐替尼联合载药微球经动脉化疗栓塞和肝动脉灌注化疗治疗>7 cm肝细胞癌伴门静脉癌栓
- Author:
Licong LIANG
1
;
Kangshun ZHU
;
Huanwei CHEN
;
Jian ZHANG
;
Nianping CHEN
;
Wensou HUANG
;
Yongjian GUO
;
Yaohong LIU
;
Cao DAN
;
Xiaoguang LIU
;
Mingyue CAI
Author Information
1. 广州医科大学附属第二医院微创介入科，广州 510260
- Publication Type:Journal Article
- Keywords:
Carcinoma ,hepatocellular;
Prognosis;
Lenvatinib;
Transarterial chemoembolization;
Hepatic arterial infusion chemotherapy
- From:
Chinese Journal of General Surgery
2025;40(5):353-359
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of lenvatinib plus drug-eluting bead transarterial chemoembolization (DEB-TACE) and FOLFOX-based hepatic arterial infusion chemotherapy (Len+DEB-TACE+HAIC) versus lenvatinib plus DEB-TACE (Len+DEB-TACE) for hepatocellular carcinoma (HCC) larger than 7 cm with portal vein tumor thrombosis (PVTT).Methods:The data from patients diagnosed with HCC (>7 cm) and PVTT who received either Len+DEB-TACE+HAIC ( n=99) or Len+DEB-TACE ( n=102) between July 2019 and June 2021 at six institutions in China were collected and retrospectively analyzed. Tumor responses were evaluated based on modified Response Evaluation Criteria in Solid Tumors. Objective response rate (ORR), disease control rate (DCR), time to progression (TTP), overall survival (OS), and treatment-related adverse event (TRAE) were compared between the two groups by propensity score matching. Subgroup analyses were performed for TTP and OS. Results:After propensity score matching, 83 pairs of patients were included in the study cohorts. The ORR for the Len+DEB-TACE+HAIC group and the Len+DEB-TACE group was 66.3% and 38.6% ( χ2=12.78, P<0.001), respectively. The DCR for the Len+DEB-TACE+HAIC group and the Len+DEB-TACE group was 91.6% and 79.5% ( χ2=4.87, P=0.027), respectively. The median TTP and median OS for the Len+DEB-TACE+HAIC group were significantly longer than those for the Len+DEB-TACE group (TTP, 10.1 months vs. 6.1 months, χ2=35.28, P<0.001; OS, 17.3 months vs. 12.9 months, χ2=16.84, P<0.001). The incidence of ≥grade 3 TRAEs was 38.6% in the Len+DEB-TACE+HAIC group and 33.7% in the Len+DEB-TACE group ( χ2=0.42, P=0.518). Conclusion:Compared with Len+DEB-TACE, Len+DEB-TACE+HAIC led to improved tumor response, TTP and OS with an acceptable safety profile in patients with large HCC and PVTT.
