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信迪利单抗联合贝伐珠单抗用于晚期不可切除肝细胞癌患者

TACE后的临床观察
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魏 磊 ，刘 演 ，吴 焱 ，卫 武 ，强 铭（1.解放军联勤保障部队第九〇一医院肿瘤科，合肥 230031；
2.中国科学院合肥肿瘤医院肿瘤科，合肥 230022；3.安徽医科大学附属第二医院肿瘤科，合肥 260301）
中图分类号 R979.1；R735.7 文献标志码 A 文章编号 1001-0408（2024）24-3029-06
DOI 10.6039/j.issn.1001-0408.2024.24.11

摘 要 目的 观察信迪利单抗联合贝伐珠单抗用于晚期不可切除肝细胞癌（HCC）患者肝动脉化疗栓塞术（TACE）后的疗效、肿
瘤标志物及免疫功能，以及用药后的安全性。方法 选取2022年6－12月于解放军联勤保障部队第九〇一医院就诊的120例晚期
不可切除HCC患者，按随机数字表法分为对照组（n＝60）和研究组（n＝60）。两组患者均接受TACE，在此基础上，对照组患者给
予甲苯磺酸索拉非尼片，研究组患者给予信迪利单抗注射液+贝伐珠单抗注射液。观察两组患者治疗3个月后的疗效、肿瘤标志
物（甲胎蛋白、癌胚抗原、糖类抗原199）、免疫功能指标（CD3 、CD4 、CD8 、CD4 /CD8）水平及不良反应发生情况。结果 治疗后，
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两组患者的客观缓解率、疾病控制率、死亡率、中位无进展时间比较，差异均无统计学意义（P＞0.05），研究组患者的中位总生存时
间显著长于对照组（P＜0.05）；两组患者的肿瘤标志物水平、免疫功能指标水平（除外CD8）均显著低于同组治疗前，且研究组的
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肿瘤标志物水平均显著低于对照组，免疫功能指标水平（除外CD8）显著高于对照组（P＜0.05）。两组患者3级不良反应发生率以
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及甲状腺功能减退、免疫相关性肺炎等1～2级不良反应发生率比较，差异均无统计学意义（P＞0.05）。结论 信迪利单抗联合贝伐
珠单抗能有效改善晚期不可切除HCC患者经TACE后的免疫功能，提高总生存时间，降低肿瘤标志物水平，且安全性较好。
关键词 肝细胞癌；晚期不可切除；信迪利单抗；贝伐珠单抗；肝动脉化疗栓塞术；疗效；免疫功能
Clinical observation of sintilimab combined with bevacizumab in the treatment of advanced unresectable
liver cancer after transcatheter arterial chemoembolization
WEI Lei ，LIU Yan ，WU Yan ，WEI Wu ，QIANG Ming（1. Dept. of Oncology， No. 901 Hospital of Joint
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Service Support Force of PLA， Hefei 230031， China；2. Dept. of Oncology， Hefei Cancer Hospital of Chinese
Academy of Sciences， Hefei 230022， China；3. Dept. of Oncology， the Second Hospital of Anhui Medical
University， Hefei 260301， China）
ABSTRACT OBJECTIVE To observe the efficacy， tumor markers， immune function and safety of sintilimab combined with
bevacizumab in the treatment of advanced unresectable hepatocellular carcinoma （HCC） after transcatheter arterial chemoembolization
（TACE）. METHODS A total of 120 patients with advanced unresectable HCC in No.901 Hospital of Joint Service Support Force
of PLA from June 2022 to December 2022 were selected and divided into control group （n＝60） and study group （n＝60） using
the random number method. Both groups received TACE. The control group was treated with Sorafenib mesylate tablets， and the
study group was treated with Sintilimab injection combined with Bevacizumab injection. The clinical efficacy， tumor markers
（alpha-fetoprotein， carcinoembryonic antigen， carbohydrate antigen 19-9）， immune function indexes （CD3 ， CD4 ， CD8 ， CD4 /
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CD8 ）， and adverse reactions of the two groups were observed after three months of treatment. RESULTS After the treatment，
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there was no significant difference between the two groups in objective remission rate， disease control rate， mortality rate， or
median progression-free survival （P＞0.05）. The median overall survival of the study group was significantly longer than control
group （P＜0.05）. After treatment， the levels of tumor markers and immune function （except for CD8 ） in both groups were
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significantly lower than before treatment； the average levels of tumor markers in the study group were significantly lower than
control group， while the levels of immune function （except for CD8 ） were significantly higher than control group （P＜0.05）.
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There was no statistically significant difference in the incidence of grade 3 adverse reactions， as well as the incidence of grade 1-2
adverse reactions such as hypothyroidism and immune-related pneumonia between the two groups （P＞0.05）. CONCLUSIONS For
advanced unresectable HCC patients undergoing TACE， bevacizumab combined with sintilimab can effectively improve immune
function， reduce tumor markers and improve the overall survival with good safety.
KEYWORDS hepatocellular carcinoma； advanced unresectable；
Δ 基金项目 安徽省自然科学基金项目（No.AHWJ2021b007）
＊第一作者 副主任医师。研究方向：常见恶性肿瘤的综合治疗。 sintilimab； bevacizumab； transcatheter arterial chemoemboli-
E-mail：weileixxxwl@sina.com zation； efficacy； immune function

中国药房 2024年第35卷第24期 China Pharmacy 2024 Vol. 35 No. 24 · 3029 ·