Clinical Study Of Apatinib Combined With Transcatheter Arterial Chemoembolization In Patients With Advanced Hepatocellular Carcinoma

Objective By observing the survival status of patients with intermediate and advanced hepatocellular carcinoma(HCC)who underwent transcatheter arterial chemoembolization(TACE)combined with apatinib and TACE alone,the efficacy of apatinib was observed;and analyze the safety of treatment.Methods From January 2018 to June 2019,Observe a total of 48 patients with intermediate and advanced HCC admitted to Hangzhou Xixi Hospital.Group A received TACE alone and group B received TACE combined with apatinib.To follow up and compare the changes in the level of a-fetal protein(AFP)at 3 months and the objective response rate(ORR)at 3,6,9 and 12 months between these two groups.Furthermore,to compare the median progression-free survival(PFS)and the incidence of adverse events between these two groups.Results Follow-up to June 2019,2 patients died in group B,and a total of 46 patients could be evaluated.After 3 months of treatment,the AFP levels in group A and group B were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).However,there was no significant difference in AFP levels between the two groups(P>0.05).The ORR of group A was 37.5%,20.83%,12.5%,4.17%after 3,6,9 and 12 months of treatment,while the ORR of group B was 54.55%,45.45%,40.91%,27.27%after 3,6,9 and 12 months of treatment.There were no statistical differences in ORR between these two groups at 3 and 6 months(P>0.05);while at 9 and 12 months after treatment,the differences between these 2 groups were statistically significant(P<0.05).The median PFS of group A was 6 months and 12 months in group B,and the differences were statistically significant(P<0.05).Adverse reactions associated with apatinib,such as hypertension,hand-foot syndrome(HFSR)and proteinuria,the incidence of group B was higher than group A,and the differences were statistically significant(P<0.05).Most of these adverse reactions can be alleviated after symptomatic treatment.Conclusion For patients with advanced HCC,TACE combined with apatinib treatment can obtain higher ORR and prolong the median PFS than TACE alone,and it has certain safety.