Comparative Study Of TACE Combined With Camrelizumab And TACE Alone In The Treatment Of Advanced Hepatocellular Carcinoma

Objective: 1.To explore whether the treatment of TACE combined with Camrelizuma is better than that of TACE alone in the treatment of advanced Hepatocellular Carcinoma.2.To observe the adverse reactions of Camrelizuma combined with TACE in the treatment of advanced liver cancer.Methods: A total of 44 patients with advanced primary liver cancer in our hospital from June 2019 to June 2020 were divided into two groups according to different treatment methods: 22 cases in the group treated with camrelizuma plus TACE and 22 cases in the group treated with TACE alone.The general clinical data,laboratory examination,complications after treatment,days of hospitalization,number of TACE and times of use of camrelizuma were recorded in the two groups.The tumor treatment of the two groups was followed up at 1,3,5 and 7 months after treatment;the best curative effect and the corresponding month tumor objective remission rate and disease control rate were calculated,and the progression-free survival time and overall survival time of the patients were followed up.The above data were collected and analyzed.The difference was statistically significant(p < 0.05).Results: The two groups of patients with different treatment methods were followed up effectively,and 44 patients were followed up for 9-21 months.1.General conditions of the two groups: There was no significant difference in general clinical data(age,sex,BCLC stage,Child-pugh grade,physical ECOG score,distant metastasis,presence of portal vein tumor thrombus and tumor blood supply,etc.)and laboratory related tests(liver function,coagulation function and AFP,etc.)between the two groups,but the data between the two groups were comparable(P>0.05).2.There was no significant difference between the two groups in the frequency of TACE treatment,the incidence of postoperative embolism syndrome and the average postoperative hospital stay between the two groups(P > 0.05).3.Evaluation of local curative effect.Statistics on the sum of arterial enhancement diameters examined by tumor imaging at 1,3,5 and 7 months after operation.(1)the best curative effect of each patient was recorded.The objective remission rate of Carmrelizumab combined with TACE group(81.82%)was significantly higher than that of TACE alone(50.0%),and the difference was statistically significant.(2)3 months after operation,the objective remission rate of TACE combined with Carrell monoclonal antibody group(77.27%)was significantly higher than that of TACE group(45.45%).(3)The objective remission rate and disease control rate in the combined treatment group were significantly higher than those in the TACE group at 5 and 7months after operation,and there was significant difference between the two groups(P< 0.05).4.Comparison of progression-free survival time and overall survival time.Among the44 patients,there were still 2 patients whose progression-free survival time was not reached,1 case in Carmrelizumab plus TACE group and 1 case in TACE group,12 cases in Carmrelizumab plus TACE group and 7 cases in TACE group did not reach the overall survival time.There was significant difference in progression-free survival between the two groups(P < 0.05).The median progression-free survival in TACE group treated with carmrelizumab combined with TACE was significantly higher than that in TACE group.There was a significant difference in overall survival time between the two groups.The median OS of carmrelizumab combined with TACE was 15.00(95% CI 11.66-18.34)months,which was significantly higher than that of TACE alone(10.00)(95% CI 8.02-11.98)months.5.Carmrelizumab in the treatment of adverse reactions.The incidence of immune-related adverse reactions was 100%;reactive capillary hyperplasia was found in 18 cases(81.82%),including primary reaction in 15 cases(68.18%),secondary reaction in 3 cases(13.6%).loss of appetite in 6 cases(27.27%),fatigue in 2 cases(9.1%),infusion reaction in 1 case(4.54%),diarrhea in 2 cases(9.1%),leukopenia in 2cases(9.1%).Hyperthyroidism occurred in 2 cases(9.1%)and alanine kinase increased in 3 cases(13.6%).Conclusion 1.TACE combined with Carmrelizumab has more advantages than TACE alone in the treatment of advanced liver cancer.2.The incidence of immune adverse reactions in the treatment of advanced liver cancer is high,but the grade is generally low,and the occurrence of adverse reactions may be related to the curative effect.TACE combined with Carmrelizumab is safe and effective in the treatment of advanced liver cancer.