Department of Hepato-Pancreato-Biliary & Gastric Medical Oncology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, 310022, Zhejiang, China.
Postgraduate Training Base Alliance of Wenzhou Medical University, Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang, China.
Clin Transl Oncol. 2024 Dec;26(12):3075-3084. doi: 10.1007/s12094-024-03498-1. Epub 2024 May 27.
The purpose of this study is to compare the efficacy and safety of transarterial chemoembolization (TACE) alone with transarterial chemoembolization combined with the arterial infusion of bevacizumab (TACE + Bev) in patients with unresectable hepatocellular carcinoma (uHCC).
A retrospective analysis was conducted on 446 uHCC patients treated with TACE or TACE + Bev between January 2021 and March 2023. The study evaluated objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse events in both treatment groups.
Finally, the TACE group comprised 295 patients, and the TACE + Bev group comprised 151 patients. Patients in the TACE + Bev group exhibited significantly prolonged median PFS (7.9 months vs. 10.3 months, P = 0.013) and median OS (16.1 months vs. 21.4 months, P = 0.041), improved ORR (26.8% vs. 37.7%, P = 0.017) and DCR (71.5% vs. 80.8%, P = 0.033) compared to the TACE group. Multifactorial Cox analysis identified alpha-fetoprotein (AFP) > 400 ng/ml as an independent prognostic factor for PFS and OS. Meanwhile, portal vein cancer thrombosis and distant metastasis are poor prognostic factors for OS. The overall incidence of adverse events was similar between the two groups.
In comparison with the TACE group, the TACE + Bev group demonstrated efficacy in improving outcomes for patients with uHCC with a manageable safety profile.
本研究旨在比较单纯经动脉化疗栓塞（TACE）与 TACE 联合贝伐珠单抗动脉灌注（TACE+Bev）治疗不可切除肝细胞癌（uHCC）患者的疗效和安全性。
回顾性分析了 2021 年 1 月至 2023 年 3 月期间接受 TACE 或 TACE+Bev 治疗的 446 例 uHCC 患者。研究评估了两组患者的客观缓解率（ORR）、疾病控制率（DCR）、无进展生存期（PFS）、总生存期（OS）和不良事件。
最终，TACE 组 295 例，TACE+Bev 组 151 例。TACE+Bev 组患者的中位 PFS（7.9 个月 vs. 10.3 个月，P=0.013）和 OS（16.1 个月 vs. 21.4 个月，P=0.041）明显延长，ORR（26.8% vs. 37.7%，P=0.017）和 DCR（71.5% vs. 80.8%，P=0.033）也得到改善。多因素 Cox 分析发现，甲胎蛋白（AFP）>400ng/ml 是 PFS 和 OS 的独立预后因素。同时，门静脉癌栓和远处转移是 OS 的不良预后因素。两组不良事件总发生率相似。
与 TACE 组相比，TACE+Bev 组在改善 uHCC 患者结局方面具有疗效，且安全性可管理。
