肝动脉灌注化疗联合伦伐替尼和 PD-1 抑制剂治疗伴有门静脉瘤栓的肝细胞癌的门静脉分流:一项回顾性队列研究

IF 4.2 3区 医学 Q2 ONCOLOGY
Guanxiong Liu, Duo Zhu, Quansheng He, Churen Zhou, Li He, Zhengran Li, Zaibo Jiang, Mingsheng Huang, Boyang Chang, Chun Wu
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引用次数: 0

摘要

目的:本研究旨在评估肝动脉灌注化疗(HAIC)与来伐替尼(LEN)和PD-1抑制剂联合治疗门静脉肿瘤血栓(PVTT)肝细胞癌(HCC)患者动脉门静脉分流(APS)的有效性和安全性:本研究采用回顾性方法,纳入了2021年1月至2023年10月期间在本中心接受HAIC、LEN和PD-1抑制剂治疗的54例APS和PVTT肝癌患者。对APS改善、APS再通、肿瘤反应、PVTT反应率、总生存期(OS)、肝内无进展生存期(InPFS)和不良事件进行了评估:42名患者(77.8%)的APS有所改善,所有改善均发生在两个疗程内。40名患者(74.1%)实现了APS完全闭塞,没有发生再闭塞。两次 HAIC 治疗后的最佳客观反应率(ORR)和 ORR 分别为 74.1%和 66.7%。最佳PVTT反应率和两次HAIC治疗后的PVTT反应率分别为98.1%和94.4%。中位OS和InPFS分别为10.0个月和5.0个月。与无APS闭塞的患者相比,有APS闭塞的患者的OS和InPFS更长(OS为12.1个月 vs 4.4个月,P< 0.001,InPFS为6.2个月 vs 2.3个月,P=0.049)。ALBI分级、肝外扩散、APS消失是OS的潜在预后因素,而APS分级和肝外扩散与InPFS独立相关。无治疗相关死亡发生:结论:HAIC与LEN和PD-1抑制剂联合治疗PVTT合并HCC的APS既有效又安全,可改善患者生存。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hepatic Arterial Infusion Chemotherapy Combined with Lenvatinib and PD-1 Inhibitors for Managing Arterioportal Shunt in Hepatocellular Carcinoma with Portal Vein Tumor Thrombus: A Retrospective Cohort Study
Purpose: This study aimed to assess the effectiveness and safety of combining hepatic arterial infusion chemotherapy (HAIC) with lenvatinib (LEN) and PD-1 inhibitors in treating arterioportal shunt (APS) in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT).
Patients and Methods: Conducted retrospectively, the study enrolled 54 HCC patients with APS and PVTT treated with HAIC, LEN, and PD-1 inhibitors at our center between January 2021 and October 2023. APS improvement, APS recanalization, tumor response, PVTT response rate, overall survival (OS), intrahepatic progression-free survival (InPFS), and adverse events were evaluated.
Results: APS improvement was observed in 42 patients (77.8%), with all improvement occurring within two treatment sessions. Complete APS occlusion was achieved in 40 patients (74.1%), and no recanalization occurred. The best objective response rate (ORR) and ORR after two HAIC sessions were 74.1% and 66.7%, respectively. The best PVTT response and PVTT response after two HAIC sessions were 98.1% and 94.4%, respectively. The median OS and InPFS were 10.0 months and 5.0 months, respectively. OS and InPFS were longer in patients with APS occlusion compared to those without (OS 12.1 vs 4.4 months, P< 0.001, InPFS 6.2 vs 2.3 months, P=0.049). ALBI grade, extrahepatic spread, APS disappearance were potential prognostic factors for OS, while APS grade and extrahepatic spread being independently associated with InPFS. No treatment-related mortality occurred.
Conclusion: Combining HAIC with LEN and PD-1 inhibitors proves to be both effective and safe in managing APS in HCC with PVTT, potentially improving patient survival.

Keywords: hepatocellular carcinoma, shunt, portal vein tumor thrombus, hepatic arterial infusion chemotherapy, combination therapy
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来源期刊
CiteScore
0.50
自引率
2.40%
发文量
108
审稿时长
16 weeks
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