PDF(Pubmed)
Abstract：
BACKGROUND: This study was designed to investigate the clinical efficacy and safety of Gamma Knife® combined with transarterial chemoembolization (TACE) and immunotherapy in the treatment of primary liver cancer.
OBJECTIVE: To investigate the clinical efficacy and safety of Gamma Knife® combined with TACE and immune-targeted therapy in the treatment of primary liver cancer.
METHODS: Clinical data from 51 patients with primary liver cancer admitted to our hospital between May 2018 and October 2022 were retrospectively collected. All patients underwent Gamma Knife® treatment combined with TACE and immunotherapy. The clinical efficacy, changes in liver function, overall survival (OS), and progression-free survival (PFS) of patients with different treatment responses were evaluated, and adverse reactions were recorded.
RESULTS: The last follow-up for this study was conducted on October 31, 2023. Clinical evaluation of the 51 patients with primary liver cancer revealed a partial response (PR) in 27 patients, accounting for 52.94% (27/51); stable disease (SD) in 16 patients, accounting for 31.37% (16/51); and progressive disease (PD) in 8 patients, accounting for 15.69% (8/51). The objective response rate was 52.94%, and the disease control rate was 84.31%. Alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and alpha-fetoprotein isoform levels decreased after treatment compared with pretreatment (all P = 0.000). The median OS was 26 months [95% confidence interval (95%CI): 19.946-32.054] in the PR group and 19 months (95%CI: 14.156-23.125) in the SD + PD group, with a statistically significant difference (P = 0.015). The median PFS was 20 months (95%CI: 18.441-34.559) in the PR group and 12 months (95%CI: 8.745-13.425) in the SD + PD group, with a statistically significant difference (P = 0.002). Common adverse reactions during treatment included nausea and vomiting (39.22%), thrombocytopenia (27.45%), and leukopenia (25.49%), with no treatment-related deaths reported.
CONCLUSIONS: Gamma Knife® combined with TACE and immune-targeted therapy is safe and effective in the treatment of primary liver cancer and has a good effect on improving the clinical benefit rate and liver function of patients.
OBJECTIVE: To investigate the clinical efficacy and safety of Gamma Knife® combined with TACE and immune-targeted therapy in the treatment of primary liver cancer.
METHODS: Clinical data from 51 patients with primary liver cancer admitted to our hospital between May 2018 and October 2022 were retrospectively collected. All patients underwent Gamma Knife® treatment combined with TACE and immunotherapy. The clinical efficacy, changes in liver function, overall survival (OS), and progression-free survival (PFS) of patients with different treatment responses were evaluated, and adverse reactions were recorded.
RESULTS: The last follow-up for this study was conducted on October 31, 2023. Clinical evaluation of the 51 patients with primary liver cancer revealed a partial response (PR) in 27 patients, accounting for 52.94% (27/51); stable disease (SD) in 16 patients, accounting for 31.37% (16/51); and progressive disease (PD) in 8 patients, accounting for 15.69% (8/51). The objective response rate was 52.94%, and the disease control rate was 84.31%. Alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and alpha-fetoprotein isoform levels decreased after treatment compared with pretreatment (all P = 0.000). The median OS was 26 months [95% confidence interval (95%CI): 19.946-32.054] in the PR group and 19 months (95%CI: 14.156-23.125) in the SD + PD group, with a statistically significant difference (P = 0.015). The median PFS was 20 months (95%CI: 18.441-34.559) in the PR group and 12 months (95%CI: 8.745-13.425) in the SD + PD group, with a statistically significant difference (P = 0.002). Common adverse reactions during treatment included nausea and vomiting (39.22%), thrombocytopenia (27.45%), and leukopenia (25.49%), with no treatment-related deaths reported.
CONCLUSIONS: Gamma Knife® combined with TACE and immune-targeted therapy is safe and effective in the treatment of primary liver cancer and has a good effect on improving the clinical benefit rate and liver function of patients.
摘要：
背景：本研究旨在研究伽玛刀®联合经动脉化疗栓塞（TACE）和免疫疗法治疗原发性肝癌的临床疗效和安全性。
目的：探讨伽玛刀联合TACE及免疫靶向治疗原发性肝癌的临床疗效和安全性。
方法：回顾性收集2018年5月至2022年10月我院收治的51例原发性肝癌患者的临床资料。所有患者均接受伽玛刀®治疗联合TACE和免疫疗法。临床疗效,肝功能的变化，总生存期（OS），评估了不同治疗反应的患者的无进展生存期（PFS），并记录不良反应。
结果：这项研究的最后一次随访是在2023年10月31日进行的。51例原发性肝癌患者的临床评估显示27例患者的部分反应（PR），占52.94%(27/51);16例疾病稳定(SD),占31.37%(16/51);进展性疾病(PD)8例,占15.69%(8/51)。客观有效率为52.94%,疾病控制率为84.31%。丙氨酸转氨酶,天冬氨酸转氨酶,乳酸脱氢酶,与治疗前相比，治疗后甲胎蛋白同工型水平下降（所有P=0.000）。PR组的中位OS为26个月[95％置信区间（95CI）：19.946-32.054]，SD+PD组为19个月（95CI：14.156-23.125），差异有统计学意义(P=0.015)。PR组的中位PFS为20个月(95CI:18.441-34.559),SD+PD组的中位PFS为12个月(95CI:8.745-13.425),差异有统计学意义(P=0.002)。治疗过程中常见的不良反应包括恶心呕吐(39.22%),血小板减少症（27.45%），和白细胞减少症（25.49%），无治疗相关死亡报告。
结论：伽玛刀®联合TACE及免疫靶向治疗原发性肝癌安全有效，对提高患者临床获益率及肝功能均有较好的效果。
目的：探讨伽玛刀联合TACE及免疫靶向治疗原发性肝癌的临床疗效和安全性。
方法：回顾性收集2018年5月至2022年10月我院收治的51例原发性肝癌患者的临床资料。所有患者均接受伽玛刀®治疗联合TACE和免疫疗法。临床疗效,肝功能的变化，总生存期（OS），评估了不同治疗反应的患者的无进展生存期（PFS），并记录不良反应。
结果：这项研究的最后一次随访是在2023年10月31日进行的。51例原发性肝癌患者的临床评估显示27例患者的部分反应（PR），占52.94%(27/51);16例疾病稳定(SD),占31.37%(16/51);进展性疾病(PD)8例,占15.69%(8/51)。客观有效率为52.94%,疾病控制率为84.31%。丙氨酸转氨酶,天冬氨酸转氨酶,乳酸脱氢酶,与治疗前相比，治疗后甲胎蛋白同工型水平下降（所有P=0.000）。PR组的中位OS为26个月[95％置信区间（95CI）：19.946-32.054]，SD+PD组为19个月（95CI：14.156-23.125），差异有统计学意义(P=0.015)。PR组的中位PFS为20个月(95CI:18.441-34.559),SD+PD组的中位PFS为12个月(95CI:8.745-13.425),差异有统计学意义(P=0.002)。治疗过程中常见的不良反应包括恶心呕吐(39.22%),血小板减少症（27.45%），和白细胞减少症（25.49%），无治疗相关死亡报告。
结论：伽玛刀®联合TACE及免疫靶向治疗原发性肝癌安全有效，对提高患者临床获益率及肝功能均有较好的效果。
