在多中心的回顾性研究 (GUIDANCE002) 中,新辅助药用铁酶和免疫检查点抑制剂进行的跨动脉化学栓塞改善了可切除肝细胞癌的生存率 (GUIDANCE002)
Da-Long Yang1, Chuang Qin2, Ning Peng3
1Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, China.
Communications medicine
|March 13, 2026
概括
新辅助三重疗法改善了肝癌患者的生存率,但增加了风险. 这种治疗为肝细胞癌 (HCC) 提供了更好的整体存活率 (OS) 和无事件存活率 (EFS),但需要仔细监测并发症.
科学领域:
- 肝细胞癌研究 肝细胞癌研究
- 瘤学治疗策略 癌症治疗策略
- 手术瘤学手术瘤学
背景情况:
- 肝切除术是中级/高级肝细胞癌 (HCC) 的关键治疗方法.
- 新辅助三重疗法的作用 (用氨酸激酶和免疫检查点抑制剂进行跨动脉化学栓塞) 在肝切除术前对HCC的作用尚未确立.
研究的目的:
- 为了评估新辅助三重疗法的疗效和安全性,与可切除的中间或高级HCC的直接肝切除相比.
- 分析整体存活率 (OS),无事件存活率 (EFS) 和术后结果.
主要方法:
- 对583名可切除HCC患者接受新辅助三重疗法 (n=205) 或直接肝切除术 (n=378) 的回顾性比较.
- 分析包括倾向分数匹配 (PSM) 和新辅助疗法后接受肝切除术的患者的亚组分析.
主要成果:
- 与直接肝切除相比,新辅助三重疗法显示显著更高的生存率和更长的中位数EFS.
- 在新辅助三重疗法后接受肝切除术的患者有显著改善的OS和EFS.
- 完整的病理反应率为34.0%,但严重的不良事件和并发症 (例如,肝功能衰竭,胆汁泄漏) 较高.
结论:
- 新辅助三重疗法为可切除的中间/高级HCC.患者提供生存益处 (OS和EFS).
- 治疗与不良事件和术后并发症的风险增加有关,需要仔细选择和管理患者.
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