| Objective: The morbidity and mortality of liver cancer and its very short natural survival time pose a serious threat to human health,and its treatment is still a difficult problem in the world.Sorafenib has opened the door of molecular targeted therapy for liver cancer and has been written into a guide for first-line treatment of advanced liver cancer,bringing hope for patients with advanced liver cancer.However,its high cost and not uncommon complications limit its application to some extent.Apatinib is a molecular targeted drug developed independently in China,and the efficacy of apatinib combined with transcatheter arterial chemoembolization(TACE)has been preliminarily verified.This study is to explore the safety and efficacy of apatinib combined with transcatheter arterial chemoembolization(TACE)in the treatment of BCLC stage B or C hepatocellular carcinoma(HCC),in order to provide more treatment options for patients.Methods:The clinical data of patients with BCLC stage B or C liver cancer in the Hepatobiliary and Pancreatic diagnosis and treatment Center of Taihe Hospital in Shiyan City from August 2017 to August 2019 were collected.According to the inclusion and exclusion criteria,216 patients were selected for the study,including 35 patients in the exposure group(apatinib combined with TACE treatment)and181patients in the non-exposure group(TACE treatment).The propensity score matching method(PSM)was used to balance the covariates of the two groups.After1:1 matching,a total of 29 pairs of patients in the two groups were included in the study,and all patients finally included in the study were followed up for at least 12 months.The efficacy,survival rate,survival time,changes of laboratory indicators and the incidence of adverse reactions were compared between the two groups.Results: The short-term effects of exposure group and non-exposure group were as follows: complete response(CR)was1(3.4%)and 0(0%),partial response(PR)was18(62.1%)and 13(44.8%),stable diseases(SD)was 6(20.7%)and 4(13.8%),and progressive diseases(PD)was 4(13.8%)and 12(41.4%),respectively.The objective response rate(ORR)of exposure group and non-exposure group was 65.5% and 44.8%,respectively.The disease control rate(DCR)of exposure group and non-exposure group was 86.2% and 58.6% respectively,and the difference was also statistically significant(P<0.05).There was no difference in the 3-month survival rate between the two groups,the 6-month survival rate was 82.8% and 55.2% respectively(P < 0.05),and the12-month survival rate was 58.6% and 37.9% respectively(P<0.05).By drawing the Kaplan-Meier survival curve,it was found that the median overall survival time(m OS)in the exposed group and the non-exposed group was 12.16(95%CI 11.633,12.687)and6.07(95%CI 4.213,8.187)months,respectively.There was significant difference in survival time between the two groups(P<0.05).After 3 months of treatment,the level of alpha-fetoprotein(AFP)in the two groups was significantly lower than that before treatment(P<0.05),and the level of AFP in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).The incidence of hypertension,hand-foot syndrome and bleeding in the non-exposure group was significantly higher than that in the control group,and the difference was statistically significant,while there was no significant difference in fatigue,diarrhea and other adverse reactions.Conclusion: Apatinib combined with TACE is safe and effective in the treatment of BCLC stage B or C hepatocellular carcinoma(HCC).It can effectively delay tumor progression and improve the effect of tumor treatment.It may bring more treatment options for patients with advanced HCC. |
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