外放疗联合仑伐替尼和卡瑞利珠单抗治疗不可切除肝癌的疗效与安全性评价
Efficacy and Safety of External Radiation Therapy Combined with Lenvatinib and Camrelizumab in treatment of Unresectable Hepatocellular Carcinoma
投稿时间:2024-03-23  修订日期:2024-04-18
DOI:
中文关键词:  肝细胞癌 放射治疗 仑伐替尼 卡瑞利珠单抗
英文关键词:hepatocellular carcinoma, radiation therapy, lenvatinib, camrelizumab
基金项目:福州市科技计划项目(2020-S-112)、福建医科大学启航基金( 2021QH1161)
作者单位邮编
季洪兵* 福建医科大学孟超肝胆医院(福州市传染病医院、福建省传染病诊疗中心)放疗科 350025
摘要点击次数: 28
全文下载次数: 0
中文摘要:
      摘要 目的:系统治疗被推荐为不可切除的肝细胞癌(HCC)的一线治疗方法。局部治疗联合系统治疗已显示出良好的生存获益。本研究的目的是评价外放疗联合仑伐替尼和卡瑞利珠单抗治疗不可切除肝癌的疗效和安全性。方法:回顾性分析福建医科大学孟超肝胆医院2018年5月1日至2021年3月1日收治85例不可切除的HCC病例,30例不可切除的HCC患者纳入外放疗联合仑伐替尼和卡瑞利珠单抗组(RT+LC),55例纳入仑伐替尼和卡瑞利珠单抗组(LC)。主要研究终点为无进展生存期(PFS)和总生存期(OS)。次要研究终点包括根据改良的实体肿瘤反应评估标准评估肿瘤治疗反应,以及采用不良事件通用术语标准5.0评估的治疗相关不良事件(TRAEs)。采用单因素和多因素Cox回归分析来确定独立的预后因素。结果:RT+LC组和LC组的中位PFS分别为11.61个月和7.25个月(P=0.036)。RT+LC组和LC组的中位OS分别为20.07个月和12.03个月(P=0.019)。Cox回归分析显示,联合RT是PFS和OS的独立因素(P均< 0.05)。RT+LC组的客观缓解率(ORR)显著高于LC组(76.7% vs. 45.5%,P=0.011),而疾病控制率(DCR)无显著性差异(93.3% vs 81.8%,P=0.258)。两组间的TRAEs具有可比性。结论:外放疗联合仑伐替尼和卡瑞利珠单抗治疗不可切除肝细胞癌临床效果显著,不良反应可控,是一种安全、有效的治疗方法。
英文摘要:
      Abstract Objectives: Systematic treatment is recommended as the first-line therapy for unresectable hepatocellular carcinoma (HCC). Locoregional therapy combined with systematic therapy have shown promising survival benefit. The objective of this study was to evaluate the efficacy and safety of external radiation therapy combined with lenvatinib and camrelizumab for unresectable hepatocellular carcinoma. Methods: A retrospective analysis of 85 unresectable HCC cases were admitted to Mengchao Hepatobiliary Hospital of Fujian Medical University from May 1,2018 to March 1,2021. 30 cases with unresectable HCC patients were enrolled in external radiation therapy combined with lenvatinib and camrelizumab (RT+LC) group and 55 cases were enrolled in lenvatinib and camrelizumab group. Primary outcome was progression-free survival (PFS) and overall survival (OS). Second outcome included tumor response evaluated in accordance with modified Response Evaluation Criteria in Solid Tumors, and treat-related adverse events (TRAEs) evaluated by Common Terminology Criteria for Adverse Events 5.0. Univariable and multivariable Cox regression analyses were used to identify independent prognostic factors. Results: The median PFS was 11.61 months and 7.25 months for RT+LC group and LC group, respectively (P=0.036). The median OS was 20.07 months and 12.03 months for RT+LC group and LC group, respectively (P=0.019). Cox regression analyses indicated that the combination with RT was an independent factor for PFS and OS (all P<0.05). The objective response rate (ORR) of RT+LC group was significantly higher than LC group (76.7% vs. 45.5%, P=0.011) while the disease control rate (DCR) did not show significant difference (93.3% vs 81.8%, P=0.258). TRAEs was comparable between two groups. Conclusion: External radiation therapy combined with lenvatinib and camrelizumab is a safe and effective treatment for unresectable hepatocellular carcinoma with significant clinical effect and controllable adverse reactions.
在线阅读     查看/发表评论  下载PDF阅读器