伦瓦提尼布与放射治疗相结合,与伦瓦提尼布在晚期肝细胞癌中进行跨动脉化学血栓化
Wen-Yu Chuang1, Po-Chien Shen1, Sung-Hua Chiu2
1Department of Radiation Oncology, Tri‑Service General Hospital, National Defense Medical University, No. 325, Sec 2, Cheng-Gong Rd, Neihu, Taipei, 114, Taiwan.
BMC cancer
|October 1, 2025
概括
与伦瓦提尼布结合的放射疗法 (RT) 在晚期肝细胞癌 (HCC) 患者中显示出优异的内场控制 (IFC),与跨动脉化学栓塞 (TACE) 加伦瓦提尼布相比. 这种组合也可以保持肝功能,提供一个有前途的治疗选择.
科学领域:
- 肝胆瘤学 肝胆瘤学
- 干预性放射学 干预性放射学
- 医学瘤学 医学瘤学
背景情况:
- 晚期肝细胞癌 (HCC) 存在重大治疗挑战.
- 伦瓦提尼布是一种用于HCC管理的向疗法.
- 目前正在探索将伦瓦替尼与放射疗法 (RT) 或跨动脉化学栓塞 (TACE) 等局域疗法结合使用.
研究的目的:
- 为了比较伦瓦提尼布加RT与伦瓦提尼布加TACE在晚期HCC的疗效.
- 评估整体生存率 (OS) 和实地控制 (IFC) 作为主要结果.
- 在这个患者队列中确定OS和IFC的预测因子.
主要方法:
- 在2018年12月至2022年1月期间治疗的32名晚期HCC患者的回顾性分析.
- 患者被分为两组:伦瓦替尼 + RT (n=17) 和伦瓦替尼 + TACE (n=15).
- 使用Kaplan-Meier,Cox回归,逆治疗概率加权 (IPTW) 和细灰分析来评估结果.
主要成果:
- 两组之间没有观察到总生存时间 (OS) 的显著差异.
- 放射治疗 (RT) 加上伦瓦提尼布显著延长了实地控制 (IFC) 持续时间 (p=0.010) 和较低的一年实地失败率 (14.9%对比TACE的61.0%).
- RT组显示了显著的α-fetoprotein下降和更好的肝功能保护的趋势 (Child-Pugh评分).
结论:
- 伦瓦提尼布与放射治疗 (RT) 结合,在先进的HCC中显示出优越的局部瘤控制.
- 与TACE相比,这种组合可能有助于维护肝功能.
- RT加lenvatinib代表了对需要改善局部控制的晚期HCC患者有前途的治疗选择.
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