【摘要】 目的 探讨TACE联合靶向免疫药物治疗晚期肝细胞癌（HCC）的疗效和安全性。方法 回顾性分析2019年1月至2021年9月苏州大学附属第一医院收治的37例晚期HCC患者的临床资料。采用TACE联合靶向免疫药物治疗（联合组）16例，单纯靶向免疫治疗（单纯组）21例。Kaplan-Meier法绘制生存曲线，比较两组的中位无进展生存期（mPFS）、中位总生存期（mOS）。根据m RECIST标准进行疗效评估，比较两组的客观缓解率（ORR）、疾病控制率（DCR）。观察两组患者的不良反应发生情况。结果 联合组的mOS和mPFS分别为14.0个月（95%CI:4.59～23.41）和6.0个月（95%CI:4.04～7.96），单纯组分别为11.6个月（95%CI:4.53～18.67）和4.5个月（95%CI:3.38～6.63），差异有统计学意义（P=0.047、0.045）。联合组的ORR和DCR分别为68.75%和87.5%，较单纯组（4.76%和33.3%）均明显提高（P<0.01）。两组患者严重不良事件的发生差异无统计学意义（P=0.634）。结论 与单纯靶向免疫治疗相比，TACE联合靶向免疫药物治疗晚期HCC的疗效明显提高，且不会增加严重不良反应的发生。更多还原

【Abstract】 Objective To discuss the efficacy and safety of transarterial chemoembolization(TACE combined with targeted therapy and immune therapy in treating advanced hepatocellular carcinoma(HCC).Methods The clinical data of a total of 37 patients with advanced HCC, who were admitted to the First Affiliated Hospital of Soochow University of China between January 2019 and September 2021, were retrospectively analyzed. The patients were divided into combination group(n=16, receiving TACE combined with targeted therapy and immune therapy) and control group(n=21, receiving only targeted therapy plus immune therapy without using TACE). Survival curves were drawn by Kaplan-Meier method, the median progression-free survival(m PFS) and median overall survival(mOS) were compared between the two groups. According to mRECIST criterion, the objective response rate(ORR) and disease control rate(DCR) were compared between the two groups.The occurrences of adverse events in both groups were recorded. Results The mOS and mPFS in the combination group were 14.0 months(95%CI=4.59-23.41) and 6.0 months(95%CI=4.04-6.63) respectively, which in the control group were 11.6 months(95%CI=4.53-18.67) and 4.5 months(95%CI=3.38-7.96) respectively, the differences between the two groups were statistically significant(P=0.047 and P=0.045 respectively). The ORR and DCR in combination group were 68.75% and 87.5% respectively, which were significantly higher than 4.76%and 33.3% respectively in the control group(all P<0.01). No statistically significant difference in the incidence of severe adverse events existed between the two groups(P=0.634). Conclusion In treating advanced HCC,TACE combined with targeted therapy and immune therapy, when compared with the targeted therapy plus immune therapy, has more obvious efficacy without increasing the occurrence of serious adverse reactions.(J Intervent Radiol, 2023, 32: 441-445)更多还原