Efficacy And Safety Of Apatinib Combined With TACE In The Treatment Of Primary Hepatic Carcinoma

Objectives:To compare the serum VEGF expression,AFP,the therapeutic effects and adverse reactions of apapitatin combined with TACE and TACE in the treatment of advanced primary hepatocellular carcinoma(PHC),and to explore the therapeutic value of different treatment groups in patients with advanced PHC.Methods: Collection of 45 cases of patients with PHC diagnosed by pathology or imaging diagnosis in the oncology department of our hospital in September2016-September 2018,and there was no severe heart,lung,liver and kidney dysfunction.The 45 patients enrolled in the group were divided into group A and B according to the treatment method,The patients in Group A were treated with Apatinib combined TACE(n=22),and the patients in Group B were treated with TACE(n=23).To detect all patients before treatment 1 day,after treatment 3 days,1 week,4weeks of serum VEGF expression,befor treatment and after treatment monthly review of AFP,enhanced CT or MRI,observe the relevant adverse reactions after treatment.Analysis of the two groups of patients with treatment effect,adverse reactions,short-term efficacy and disease progress.Results:(1)There was no statistical difference in VEGF expression between the two groups before treatment(P>0.05),and both groups of VEGF increased in 3 days after treatment,there was no significant difference between the two groups(p>0.05).1week after treatment,serum VEGF decreased in both groups,and group A was lower than Group B,the difference was statistically significant(p<0.05),4 weeks after treatment,the expression of serum VEGF of the two groups increased again,but lower than 1 day before treatment,the Group B increased more obviously,the difference was statistically significant(P < 0.05);(2)The AFP was higher in both groups before treatment,the difference was not statistically significant(p>0.05),the AFP decreased in both groups after treatment,and the group A was lower than Group B,the difference was statistically significant(p<0.05);(3)After treatment,the tumors of the two groups were reduced to different degrees,In group A,3 months after treatment,OR 13 cases(59.09%),DCR 19 cases(86.36%),6 months after treatment,OR 10 cases(45.45%),and in group B,3 months after treatment OR,9 cases(39.13%)and DCR 19 cases (82.61%),6 months after treatment,OR 6 cases(26.08%),there was no significant difference between the two groups(P>0.05);6 months after treatment,in group A,DCR was 18cases(81.82%),group B DCR was 12 cases(52.17%),statistics Difference(P<0.05);(4)Both groups had different degrees of liver pain,nausea,vomiting and other TACE-related adverse reactions,Apatinib did not increase the TACE-related adverse reactions,group A has different degrees of skin rash,hand-foot syndrome,hypertension and other adverse reactions,There were statistically different differences between the two groups(p<0.05),but they were 1-2 levels of reaction,which could be alleviated after rest or symptomatic treatment,and there was no statistical difference in Apatinib related adverse reactions(p>0.05).And there was no level 4 adverse reaction in either group.Conclusions:Apatinib has synergistic effect with TACE in the treatment of PHC.TACE combined with apatinib treatment group will enhance its therapeutic effect,reduce its tumor markers,inhibition of VEGF expression,improve the treatment effect of cancer,and adverse reactions do not affect quality of life and further treatment.