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肝动脉化疗栓塞术（TACE）联合或不联合免疫靶向治疗晚期肝细胞癌伴门静脉癌栓（PVTT）：一项多中心回顾性研究

Immune-Targeted Therapy with or without Transarterial Chemoembolization (TACE) for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis (PVTT): A Multicenter Retrospective Study.

作者信息

You Ran, Cheng Yuan, Diao Lingfeng, Wang Chendong, Leng Bin, Yu Zeyu, Xu Qingyu, Yin Guowen

机构信息

Department of Interventional Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China.

Department of Oncology, Bayi Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210009, China.

出版信息

Biomedicines. 2024 Sep 19;12(9):2124. doi: 10.3390/biomedicines12092124.

DOI:10.3390/biomedicines12092124
PMID:39335637
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11429150/
Abstract

PURPOSE

In the present study, we aimed to assess the effectiveness and safety of immune-targeted therapy (IT) with or without transarterial chemoembolization (TACE) for advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT).

PATIENTS AND METHODS

This was a multicenter retrospective study that included 265 HCC patients with PVTT (IT + TACE: 82, IT: 183). Overall survival (OS) and progression-free survival (PFS), as well as tumor responses and adverse events, were evaluated.

RESULTS

Patients in the IT + TACE group experienced significantly longer overall survival (OS) and progression-free survival (PFS) periods, compared with those in the IT group (OS 19.0 vs. 13.0 months, < 0.001; PFS 12.0 vs. 7.3 months, < 0.001). Multivariable analysis confirmed IT + TACE as an independent predictor for improved OS and PFS. Subgroup analysis demonstrated the benefits of IT + TACE in patients with rich PVTT blood supply. Preoperative imaging and DSA offered predictive value.

CONCLUSIONS

TACE combined with IT provides a safe and effective treatment option for advanced-HCC patients with PVTT, particularly those with abundant PVTT blood supply.

摘要

目的

在本研究中，我们旨在评估免疫靶向治疗（IT）联合或不联合经动脉化疗栓塞术（TACE）治疗伴有门静脉癌栓（PVTT）的晚期肝细胞癌（HCC）的有效性和安全性。

患者与方法

这是一项多中心回顾性研究，纳入了265例伴有PVTT的HCC患者（IT + TACE组：82例，IT组：183例）。评估总生存期（OS）、无进展生存期（PFS）、肿瘤反应及不良事件。

结果

与IT组相比，IT + TACE组患者的总生存期（OS）和无进展生存期（PFS）显著更长（OS：19.0个月对13.0个月，<0.001；PFS：12.0个月对7.3个月，<0.001）。多变量分析证实IT + TACE是OS和PFS改善的独立预测因素。亚组分析显示IT + TACE对PVTT血供丰富的患者有益。术前影像学检查和数字减影血管造影（DSA）具有预测价值。

结论

TACE联合IT为伴有PVTT的晚期HCC患者，尤其是PVTT血供丰富的患者，提供了一种安全有效的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8b/11429150/d6322bb7f66d/biomedicines-12-02124-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8b/11429150/3228f9502200/biomedicines-12-02124-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8b/11429150/a4fd677eabd4/biomedicines-12-02124-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8b/11429150/5d3400879ca8/biomedicines-12-02124-g003a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8b/11429150/d6322bb7f66d/biomedicines-12-02124-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8b/11429150/3228f9502200/biomedicines-12-02124-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8b/11429150/a4fd677eabd4/biomedicines-12-02124-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8b/11429150/5d3400879ca8/biomedicines-12-02124-g003a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8b/11429150/d6322bb7f66d/biomedicines-12-02124-g004.jpg

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