原发性肝癌切除术后预防性肝动脉化疗栓塞术(TACE)与靶向免疫治疗回顾性疗效与安全性分析

Retrospective Efficacy and Safety Analysis of Prophylactic Transarterial Chemoembolization (TACE) and Targeted Immunotherapy after Primary Liver Cancer Resection

摘要: 目的：探讨原发性肝癌切除术后预防性肝动脉化疗栓塞术(TACE)与靶向免疫治疗疗效及安全性分析。方法：选取2018年1月~2023年12月期间于山东省济宁市第一人民医院接受原发性肝癌手术切除且术后2个月内接受预防性TACE治疗或靶向免疫治疗的患者作为研究对象。按照治疗方案不同分为A组(术后TACE治疗组，n = 20)与B组(术后靶免治疗组，n = 20)。比较两组患者预防性治疗后1月、3月及6月的肝功能指标、肿瘤标志物、凝血功能、临床疗效及不良反应发生情况。结果：两组患者预防性治疗后6个月内总体肝功能、凝血功能差异无显著性，未出现严重的骨髓抑制、肝功能衰竭等；靶免治疗组患者治疗后第1个月和第3个月AFP低于TACE治疗组，差异具有显著性(P < 0.05)；预防性治疗6个月后，靶免组的客观缓解率及疾病控制率均高于TACE组，差异具有显著性(P < 0.05)；两组患者不良反应发生率分别为45%及35%，两组患者差异无显著性(P > 0.05)。结论：对于因肝癌接受手术治疗的患者，术后预防性靶向免疫治疗在改善短期预后方面具有优势，且具有良好的安全性。

Abstract: Objective: To investigate the efficacy and safety of prophylactic transarterial chemoembolization (TACE) and targeted immunotherapy after primary hepatocellular carcinoma (HCC) resection. Methods: Patients who underwent surgical resection of primary liver cancer at the First People’s Hospital of Jining City, Shandong Province from January 2018 to December 2023 and received preventive TACE treatment or targeted immunotherapy within 2 months after surgery were selected as the research subjects. The patients were divided into Group A (post-surgery TACE group, n = 20) and Group B (post-surgery targeted immunotherapy group, n = 20) based on the treatment received. Liver function parameters, tumor markers, coagulation function, clinical efficacy, and adverse events were compared between the two groups at 1 month, 3 months, and 6 months after prophylactic treatment. [Results] Within 6 months of prophylactic treatment, there were no significant differences in overall liver function and coagulation function between the two groups, and no severe adverse events such as bone marrow suppression or liver failure were observed. The levels of alpha-fetoprotein (AFP) in the targeted immunotherapy group were significantly lower than those in the TACE group at 1 month and 3 months after treatment (P < 0.05). The objective response rate and disease control rate in the targeted immunotherapy group were higher than those in the TACE group at 6 months after prophylactic treatment, with statistically significant differences (P < 0.05). The incidence of adverse events was 45% in the TACE group and 35% in the targeted immunotherapy group, with no significant difference between the two groups (P > 0.05). Conclusion: For patients undergoing surgical treatment for liver cancer, postoperative preventive targeted immunotherapy has advantages in improving short-term prognosis and has a good safety profile.