He Benyi, Deng Min, Li Shaohua, Mei Jie, Lu Lianghe, Zuo Zhijun, Guo Rongping, Wei Wei
Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
Int J Med Sci. 2025 Feb 24;22(6):1415-1424. doi: 10.7150/ijms.108144. eCollection 2025.
Transarterial chemoembolization (TACE) is an optional treatment for hepatocellular carcinoma (HCC) patients with macrovascular invasion (MVI) and without extrahepatic metastasis (EHM). As a recently emerging approach, the efficacy of hepatic arterial infusion chemotherapy (HAIC) compared with TACE in this group of patients is unclear. Between December 2016 and June 2020, patients diagnosed with HCC with MVI and without EHM who underwent TACE (n=91) or HAIC (n=190) as their initial treatment were included. Propensity score matching (PSM) was used to reduce selection bias and other imbalances. The objective response rate (ORR), overall survival (OS), progression-free survival (PFS), rate of subsequent resection, and safety were compared between groups. Seventy-seven pairs of patients were matched after PSM. The ORR was higher in the HAIC group than that in the TACE group (29.9% vs. 9.1%, = 0.013). The median PFS of patients in the HAIC group was longer than that of the patients in the TACE group (4.7 vs. 1.4 months, = 0.002), but there was no significant difference in the median OS between the groups (19.6 vs. 18.1 months, = 0.122). HAIC also showed a better safety profile than TACE. HAIC is an effective and safe option for treating HCC patients with MVI and without EHM compared to TACE.
经动脉化疗栓塞术（TACE）是伴有大血管侵犯（MVI）且无肝外转移（EHM）的肝细胞癌（HCC）患者的一种可选治疗方法。作为一种新兴的治疗方法，在这组患者中，肝动脉灌注化疗（HAIC）与TACE相比的疗效尚不清楚。2016年12月至2020年6月，纳入了初始治疗接受TACE（n = 91）或HAIC（n = 190）的诊断为伴有MVI且无EHM的HCC患者。采用倾向评分匹配（PSM）来减少选择偏倚和其他不均衡性。比较两组之间的客观缓解率（ORR）、总生存期（OS）、无进展生存期（PFS）、后续切除率和安全性。PSM后匹配了77对患者。HAIC组的ORR高于TACE组（29.9%对9.1%，P = 0.013）。HAIC组患者的中位PFS长于TACE组患者（4.7对1.4个月，P = 0.002），但两组之间的中位OS无显著差异（19.6对18.1个月，P = 0.122）。HAIC也显示出比TACE更好的安全性。与TACE相比，HAIC是治疗伴有MVI且无EHM的HCC患者的一种有效且安全的选择。
