Clinical Study Of Chaiping Decoction Combined With Lenvatinib And Carrelizumab In The Treatment Of Unresectable Liver Cancer After TACE

Objective: To evaluate the clinical efficacy of Chaiping decoction combined with lenvatinib and carrelizumab in the treatment of unresectable liver cancer after TACE.Methods: Sixty-four patients with unresectable primary liver cancer after TACE who met the inclusion criteria were selected and divided into control group and treatment group by random number table method,32 cases in each group.Two patients in the control group wanted to take Chinese medicine and asked to withdraw.One patient in the treatment group wanted to accept other targeted / immune drug treatment and asked to withdraw.One patient could not continue to insist on taking Chinese medicine and asked to withdraw.Finally,60 cases were included,30 cases in the control group and 30 cases in the treatment group.The control group was treated with Lenvatinib Mesylate Capsules combined with Carrelizumab for injection.The treatment group was treated with Chaiping Decoction on the basis of the control group.Both groups were treated for 4 weeks,a total of 3 courses.Before treatment,4weeks and 12 weeks after treatment,the liver function(TBIL,AST,ALT,ALB),coagulation function(PT),liver cancer screening(AFP,AFP-L3,DCP),TCM symptom score,quality of life score,tumor changes,progression-free survival and adverse reactions of the two groups were observed.All results were statistically analyzed and compared to evaluate the efficacy and safety of Chaiping Decoction.Results: 1.Liver function : The liver function TBIL and ALB of the two groups were significantly improved at 4 weeks and 12 weeks after treatment,and the difference was statistically significant(P<0.05).After 12 weeks of treatment,they were lower than those before treatment,and the difference was statistically significant(P<0.05).2.Prothrombin time : There was no significant change in PT between the two groups at 4 weeks and 12 weeks after treatment(P>0.05).3.Three items of liver cancer : AFP,AFP-L3 and DCP in the two groups decreased significantly 12 weeks after treatment compared with those before treatment,and the comparison between the two groups was P>0.05.4.Efficacy of solid tumors : After 4 weeks of treatment,the objective effective rates of the treatment group and the control group were 23.33 % and 13.3 %,respectively.The tumor control rate of the treatment group was better than that of the control group(83.3% vs 73.3%).After 12 weeks of treatment,the objective effective rates of the treatment group and the control group were 40 %and 23.3 %,respectively.The tumor control rate of the treatment group was better than that of the control group(90 % vs 83.3 %).5.Quality of life score : The KPS scores of the two groups at 4 weeks and 12 weeks after treatment were significantly higher than those before treatment.The treatment group was better than the control group,and the difference was statistically significant(P< 0.05).6.TCM syndrome score : The TCM syndrome scores of the two groups were lower than those before treatment at 4 weeks and 12 weeks after treatment,and the difference was statistically significant(P<0.05).The difference was statistically significant at 12 weeks after treatment(P< 0.05).7.Progression-free survival time : The median PFS was 4.6 months in the control group and 5.7 months in the treatment group.The difference was statistically significant(P<0.05).8.Adverse reactions : The incidence of adverse reactions in the control group was 66.6 %,and the incidence of adverse reactions in the treatment group was56 %.The difference was statistically significant(P<0.05).Adverse reactions such as hypertension,hand-foot syndrome,proteinuria,nausea,loss of appetite and fatigue were statistically significant(P<0.05).There was no significant difference in adverse reactions such as reactive capillary hyperplasia,hypothyroidism,WBC decrease,PLT decrease,vomiting and diarrhea(P>0.05).9.Safety : There were no special adverse reactions in electrocardiogram,blood routine,urine routine,renal function and thyroid function before and after treatment in the two groups.Conclusion: Chaiping decoction combined with lenvatinib and carrelizumab is effective in the treatment of unresectable liver cancer after TACE.It can reduce the incidence of adverse reactions,improve liver function,reduce the level of three items of liver cancer,control the development of tumor,prolong the progression-free survival and overall survival of patients,and improve the TCM symptom score of patients.Preliminary refining Chaiping Decoction : 1Fever or conscious fever,liver pain,abdominal distension,poor appetite,nausea and vomiting,dry mouth and bitter mouth;2 or with stool is not formed,or with yellow urine,or with irritability,or with fatigue;3 red tongue,white greasy fur,slippery pulse or string slip.