| Objective:By observing the short-term efficacy,quality of life score and other clinical efficacy indicators and safety indicators after TACE in the treatment of advanced liver cancer with Fuhebeihuafang,Camrelizumab and Apatinib,and observing the improvement of related indicators of advanced liver cancer.Methods:According to the randomized controlled clinical trial,107patients were randomly divided into treatment group(54 cases)and control group(53 cases).The treatment group was treated with the combination of Cam and Apatinib for patients with advanced liver cancer after TACE,and the control group was treated with Cam and Apatinib for patients with advanced liver cancer after TACE.The short-term efficacy,treatment-related side effects,PFS,AFP of the two groups were observed and compared KPS score,TCM syndrome score,peripheral serum CD3~+T cells,CD4~+T cells,CD8~+T cells,PD-1~+CD4~+T cells,PD-1~+CD8~+T cells,TIM-3~+CD4~+T cells,TIM-3~+CD8~+T cells and other immune indicators.Results:(1)short-term effects:In the treatment group,the objective remission rate was 28%,and the disease control rate was 84.0%;The objective remission rate of the control group was 30%,and the disease control rate was 82.0%.There was no significant difference between the two groups(P>0.05).(2)Treatment related side effects:there were no severe embolism syndrome,adverse reactions and allergic reactions in the two groups of patients during the treatment,and there were no cases of death due to immune and targeted treatment-related diseases.The incidence of hypertension,reactive capillary hyperplasia,transient liver function damage and fatigue in the treatment group were significantly lower than those in the control group(P<0.05).(3)The level of immune indicators:The levels of CD3~+T cells,CD4~+T cells and CD8~+T cells in the peripheral blood serum of the two groups after 4 courses of treatment were higher than those before treatment(P<0.05),and the levels of PD-1~+CD4~+T cells,PD-1~+CD8~+T cells,TIM-3~+CD4~+T cells,TIM-3~+CD8~+T cells were lower than those before treatment(P<0.05),and the treatment group after 4 courses of treatment was significantly better than the control group(P<0.05).(4)PFS:the median PFS was 4.7 months in the treatment group and3.5 months in the control group.There was no significant difference between the two groups(P>0.05).(5)AFP level:both groups can reduce AFP level(P<0.05),and the treatment group is significantly better than the control group(P<0.05).(6)KPS score:both groups can improve the KPS score after treatment(P<0.05),and the treatment group is better than the control group(P<0.05).(7)TCM syndrome score:After 4 courses of treatment,the TCM syndrome score and total score related to liver depression and spleen deficiency in both groups were significantly lower than those before treatment(P<0.05);After 4 courses of treatment,the score and total score of TCM syndromes related to liver depression and spleen deficiency in the treatment group were significantly lower than those in the control group(P<0.05).(8)Security:There were no serious adverse reactions related to the study in both groups.The treatment group was superior to the control group in terms of adverse reactions such as hypertension and transient liver function damage(P<0.05).There is no significant change in the laboratory test results before and after treatmen.Conclusion(s):Compared with the treatment of patients with advanced liver cancer after TACE with Cam and Apatinib,the treatment of patients with advanced liver cancer after TACE with Cam and Apatinib can effectively alleviate the side effects,TCM syndromes and improve the quality of life of patients;It can also up-regulate the level of peripheral serum CD3~+T cells,CD4~+T cells,and CD8~+T cells after 4 courses of treatment,and down-regulate the expression level of peripheral serum PD-1~+CD4~+T cells,PD-1~+CD8~+T cells,TIM-3~+CD4~+T cells,and TIM-3~+CD8~+after 4 courses of treatment,which is worthy of further study. |
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