Clinical Observation Of Yiguanjian Combined With TACE In The Treatment Of Advanced Liver And Kidney Yin Deficiency Of Primary Liver Cancer

Objective: To evaluate the clinical efficacy and safety of Chinese medicine Yiguanjian combined with TACE in patients with primary liver cancer with liver and kidney yin deficiency in advanced BCLC.Methods: Eligible patients with advanced stage by BCLC clinical staging were treated with Yiguanjian combined with TACE at the the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine/Sichuan Provincial Hospital of Traditional Chinese Medicine.The endpoints were overall survival(OS)、survival rate、objective response rate(ORR)and disease control rate(DCR).And safety was also assessed by observing adverse reaction,liver and kidney function,coagulation function and other related indicators.Results: A total of 54 patients recieved Yiguanjian combined with TACE at the the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine/Sichuan Provincial Hospital of Traditional Chinese Medicine from July 20,2018 to March 31,2020.The median follow-up time was 16.76 months.The average number of TACE treatments was 2.6 times.The median OS was 10.97 months(95% confidence interval: 8.44～13.50),the 1-year survival rate was 44.44%(24/54),and the 2-year survival rate was 14.81%.Subgroup analysis showed that The median OS of the non-vascular tumor thrombus group and the vascularized tumor thrombus group were 13.16(95% confidence interval: 11.54-14.78)and 9.07 months(95% confidence interval: 8.19-9.95),respectively(P=0.023).The median OS of the alpha-fetoprotein(AFP)≤400ng/ml group and the alpha-fetoprotein(AFP)>400ng/ml group was 12.83 months(95% Confidence interval: 10.91～14.75)and 8.83 months(95% confidence interval: 7.80～9.86),respectively(P=0.001).The ORR was 0 and the DCR was 3.7%.Conclusion: Yiguanjian combined with TACE can improve OS in patients with advanced liver and kidney yin deficiency,and without intolerable toxicity;Yiguanjian combined with TACE can reduce liver damage;Yiguanjian combined with TACE is safe in the treatment of patients with advanced liver and kidney yin deficiency type primary liver cancer,without intolerable toxicity;The level of AFP and the presence or absence of tumor thrombi may be used as prognostic factors,and the superior population can be screened out.