Yan Fang, Wang Wanyu, Yang Zhiwen, Huang Yang, Rao Yan, Qu Ge, Peng Hui, Shi Ming, Zeng Weian, Chen Dongtai, Xing Wei
Department of Anesthesiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
Department of Anesthesiology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, PR China.
Br J Anaesth. 2025 Jun;134(6):1628-1637. doi: 10.1016/j.bja.2025.01.042. Epub 2025 Mar 20.
Lidocaine, the most widely used local anaesthetic, has anticancer effects in both laboratory findings and retrospective clinical studies. We explored the potential benefits of intra-arterial lidocaine on long-term survival in patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolisation (TACE).
This retrospective cohort study included patients with HCC who received TACE as initial treatment from August 2011 to October 2016. Eligible patients were categorised into no lidocaine and lidocaine groups. Propensity score matching was undertaken. Progression-free survival (PFS) and overall survival were compared between the two groups. Subgroup analysis was performed to explore the survival benefit of combining intra-arterial lidocaine with platinum-based chemotherapy during TACE.
Of 374 eligible patients, 96 were in the lidocaine group and 278 were in the no lidocaine group. Survival analysis showed that intra-arterial lidocaine was associated with longer PFS (P=0.004) and overall survival (P<0.001). After propensity score matching, PFS (P<0.001) and overall survival (P=0.001) benefits of lidocaine remained. Multivariate analysis showed that intra-arterial lidocaine was an independent prognostic factor for PFS (P=0.011) and overall survival (P=0.044). The impact of intra-arterial lidocaine was similar in patients receiving the TACE regimen with platinum (PFS: P=0.014; overall survival: P=0.023).
Intra-arterial lidocaine might improve long-term survival in patients with HCC undergoing TACE and in the subgroup of patients receiving platinum. The study highlights the potential antitumour benefits of combining lidocaine and chemotherapeutics in patients with cancer.
利多卡因是使用最广泛的局部麻醉剂，在实验室研究结果和回顾性临床研究中均具有抗癌作用。我们探讨了动脉内注射利多卡因对接受经动脉化疗栓塞术（TACE）的肝细胞癌（HCC）患者长期生存的潜在益处。
这项回顾性队列研究纳入了2011年8月至2016年10月接受TACE作为初始治疗的HCC患者。符合条件的患者分为未使用利多卡因组和利多卡因组。进行了倾向评分匹配。比较了两组的无进展生存期（PFS）和总生存期。进行亚组分析以探讨在TACE期间动脉内注射利多卡因与铂类化疗联合使用的生存益处。
在374例符合条件的患者中，96例在利多卡因组，278例在未使用利多卡因组。生存分析表明，动脉内注射利多卡因与更长的PFS（P = 0.004）和总生存期（P <0.001）相关。倾向评分匹配后，利多卡因的PFS（P <0.001）和总生存期（P = 0.001）益处仍然存在。多变量分析表明，动脉内注射利多卡因是PFS（P = 0.011）和总生存期（P = 0.044）的独立预后因素。在接受含铂TACE方案的患者中，动脉内注射利多卡因的影响相似（PFS：P = 0.014；总生存期：P = 0.023）。
动脉内注射利多卡因可能会改善接受TACE的HCC患者以及接受铂类治疗的亚组患者的长期生存。该研究突出了利多卡因与化疗药物联合用于癌症患者的潜在抗肿瘤益处。
