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HAIC-FOLFOX 联合卡瑞利珠单抗用于不可切除肝细胞癌的临

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祝 平 ，卢西雅，田艳飞（辽宁省肿瘤医院内镜科，沈阳 110042）
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中图分类号 R735.7；R969.4 文献标志码 A 文章编号 1001-0408（2025）22-2833-05
DOI 10.6039/j.issn.1001-0408.2025.22.14

摘 要 目的 探讨基于奥沙利铂和氟尿嘧啶药物组合的肝动脉灌注化疗（即HAIC-FOLFOX）联合卡瑞利珠单抗用于不可切除
肝细胞癌（HCC）的有效性和安全性。方法 回顾性收集2021年1月1日－2023年3月1日于辽宁省肿瘤医院住院治疗的222例不
可切除HCC患者的资料，根据治疗方案的不同将其分为对照组（HAIC-FOLFOX联合索拉非尼，117例）和观察组（HAIC-FOLFOX
联合卡瑞利珠单抗，105例）。比较两组患者治疗4个周期后的近期疗效指标[客观缓解率（ORR）和疾病控制率（DCR）]和远期疗
效指标[中位总生存期（mOS）和1年内中位无进展生存期（mPFS）]，治疗前及治疗4个周期后的肿瘤标志物（甲胎蛋白、癌胚抗原、
糖类抗原19-9）、免疫功能指标（CD3 、CD4 和CD8 T细胞亚群）水平，以及治疗期间的不良反应发生情况。结果 观察组患者的
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ORR为55.24%，显著高于对照组的35.90%（P＜0.05），而两组患者的DCR比较差异无统计学意义（P＞0.05）；观察组患者的mOS、
1年内mPFS（15.22、10.83个月）均显著长于对照组（11.34、8.04个月）（P＜0.05）。治疗4个周期后，两组患者的肿瘤标志物水平均
显著低于同组治疗前，观察组患者的CD3 、CD4 T细胞比例均显著高于同组治疗前（P＜0.05）；且观察组患者的上述指标均显著
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优于同期对照组（P＜0.05）。观察组发生1～3级免疫相关性肺炎、毛细管增生的患者比例均显著高于对照组（P＜0.05），而两组发
生1～3级发热、乏力、皮疹等不良反应的患者比例比较，差异均无统计学意义（P＞0.05）。结论 相较于HAIC-FOLFOX联合索拉
非尼，HAIC-FOLFOX联合卡瑞利珠单抗可显著提高不可切除HCC患者的ORR，延长mOS和1年内mPFS，有效降低肿瘤标志物
水平，改善部分免疫功能指标，但会增加免疫相关不良事件的发生风险。
关键词 肝动脉灌注化疗；卡瑞利珠单抗；索拉非尼；不可切除肝细胞癌；有效性；安全性

Clinical observation of HAIC-FOLFOX combined with camrelizumab in the treatment of unresectable
hepatocellular carcinoma
ZHU Ping，LU Xiya，TIAN Yanfei（Dept. of Endoscopy， Liaoning Cancer Hospital & Institute， Shenyang
110042， China）

ABSTRACT OBJECTIVE To investigate the efficacy and safety of hepatic arterial infusion chemotherapy based on the
oxaliplatin and fluorouracil drug combination （HAIC-FOLFOX） combined with camrelizumab in the treatment of unresectable
hepatocellular carcinoma （HCC）. METHODS The data of 222 unresectable HCC patients hospitalized at Liaoning Cancer Hospital
& Institute from January 1， 2021 to March 1， 2023 were retrospectively collected. Based on treatment regimens， patients were
divided into a control group （HAIC-FOLFOX+sorafenib， n＝117） and an observation group （HAIC-FOLFOX+camrelizumab， n＝
105）. Short-term efficacy indicators [objective remission rate （ORR） and disease control rate （DCR）] and long-term efficacy
indicators [median overall survival （mOS） and median progression-free survival （mPFS） within one year] after 4 cycles of
treatment， the levels of tumor markers （alpha fetoprotein， carcinoembryonic antigen， carbohydrate antigen 19-9）， immune function
indicators （CD3 ， CD4 ， and CD8 T-cell subsets） before treatment and after 4 cycles of treatment， as well as the occurrence of
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adverse reactions， were compared between two groups. RESULTS The ORR of the observation group was 55.24%， which was
significantly higher than 35.90% of the control group （P＜0.05）； while there was no statistically significant difference in DCR
between the two groups （P＞0.05）. The mOS and mPFS within 1 year of the observation group （15.33， 10.83 months） were
significantly longer than the control group （11.34， 8.04 months） （P＜0.05）. After 4 cycles of treatment， tumor marker levels of the
two groups were significantly lower than before treatment， and the proportions of CD3 and CD4 T cells were significantly higher
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than before treatment （P＜0.05）. Above indexes of the observation group were significantly better than the control group at the
same time （P＜0.05）. The proportions of patients in the observation group who developed grade 1-3 immune-related pneumonia and
capillary proliferation were significantly higher than the control group （P＜0.05）， while there were no statistically significant
differences in the proportions of patients experiencing grade 1-
Δ 基金项目 辽宁省科学技术计划项目（No.2022-BS-061） 3 adverse reactions such as fever， fatigue and rash between
＊第一作者 主治医师，博士。研究方向：肝癌的临床诊疗。E-mail：
two groups （P＞0.05）. CONCLUSIONS Compared with
sunyijun0513@163.com
# 通信作者 主治医师，硕士。研究方向：肝癌的临床诊疗。E-mail： HAIC-FOLFOX combined with sorafenib， HAIC-FOLFOX
fly23411015@126.com combined with camrelizumab can significantly improve the

中国药房 2025年第36卷第22期 China Pharmacy 2025 Vol. 36 No. 22 · 2833 ·