Lu Haohao, Zheng Chuansheng, Liang Bin, Xia Xiangwen, Fan Hongjie
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.
Front Oncol. 2024 Jan 17;14:1280837. doi: 10.3389/fonc.2024.1280837. eCollection 2024.
The aim of this study was to investigate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with percutaneous ethanol injection (PEI) and lenvatinib in HCC patients with PVTT (Vp2-3), thus providing a safe and effective treatment strategy for advanced HCC patients.
Clinical data of 227 patients with unresectable HCC and PVTT treated at the Union Hospital from January 2018 to December 2021 were retrospectively analyzed. The patients were divided into two groups according to their treatment methods: TACE+PEI+lenvatinib group (N=103) and TACE+lenvatinib group (N=124).
The proportion of patients with disappearance, shrinkage, or no change of PVTT after treatment was significantly higher in the TACE+PEI+lenvatinib group compared to the TACE+lenvatinib group, with statistical significance (P<0.001). The TACE+PEI+lenvatinib group had higher objective response rate (ORR) (50.5% vs. 25.8%, P<0.001) and disease control rate (DCR) (87.4% vs. 74.2%, P=0.013) than the TACE+lenvatinib group. The median progression-free survival (mPFS) of the TACE+PEI+lenvatinib group was longer than that of the TACE+lenvatinib group (8.1 months vs. 6.5 months, P<0.001). Consistently, the median overall survival (mOS) of the TACE+PEI+lenvatinib group was longer than that of the TACE+lenvatinib group (17.1 months vs. 13.9 months, P<0.001).
Among HCC patients with PVTT (Vp2-3), TACE+PEI+lenvatinib is more effective comparing to TACE+lenvatinib in prolonging PFS and OS. The control of PVTT in the TACE+PEI+lenvatinib group was significantly more satisfactory than that in the TACE+lenvatinib group. TACE+PEI+lenvatinib is a safe and effective treatment strategy for HCC patients with PVTT (Vp2-3).
本研究旨在探讨经动脉化疗栓塞术（TACE）联合经皮乙醇注射（PEI）及仑伐替尼治疗门静脉癌栓（PVTT，Vp2-3型）的肝癌患者的疗效及安全性，从而为晚期肝癌患者提供一种安全有效的治疗策略。
回顾性分析2018年1月至2021年12月在协和医院接受治疗的227例不可切除肝癌合并PVTT患者的临床资料。根据治疗方法将患者分为两组：TACE+PEI+仑伐替尼组（N=103）和TACE+仑伐替尼组（N=124）。
与TACE+仑伐替尼组相比，TACE+PEI+仑伐替尼组治疗后门静脉癌栓消失、缩小或无变化的患者比例显著更高，差异有统计学意义（P<0.001）。TACE+PEI+仑伐替尼组的客观缓解率（ORR）（50.5%对25.8%，P<0.001）和疾病控制率（DCR）（87.4%对74.2%，P=0.013）均高于TACE+仑伐替尼组。TACE+PEI+仑伐替尼组的中位无进展生存期（mPFS）长于TACE+仑伐替尼组（8.1个月对6.5个月，P<0.001）。同样，TACE+PEI+仑伐替尼组的中位总生存期（mOS）长于TACE+仑伐替尼组（17.1个月对13.9个月，P<0.001）。
在门静脉癌栓（Vp2-3型）的肝癌患者中，与TACE+仑伐替尼相比，TACE+PEI+仑伐替尼在延长无进展生存期和总生存期方面更有效。TACE+PEI+仑伐替尼组对门静脉癌栓的控制明显优于TACE+仑伐替尼组。TACE+PEI+仑伐替尼是门静脉癌栓（Vp2-3型）肝癌患者的一种安全有效的治疗策略。
