Clinical Analysis Of Apatinib Combined With TACE In The Treatment Of Advanced HCC And Its Influence On Serum VEGF/MMP-2

Objective To study the clinical efficacy of apatinib combined with transcatheter arterial chemoembolization(TACE)in the treatment of advanced hepatocellular carcinoma(HCC)and its influence on serum vascular endothelial growth factor(VEGF)and matrix metallo proteinase-2(MMP-2)levels.Methods A total of 60 patients with advanced hepatocellular carcinoma from March 2018 to December 2018 in department of hepatobiliary surgery and oncology,the central hospital of enshi tujia and miao autonomous prefecture were enrolled as the study subjects,30 cases in each group.They were divided into the experimental group and the control group by treatment plan,the experimental group received apatinib combined with TACE treatment,the control group received TACE treatment.The short-term treatment effect of the two groups of patients was evaluated,which accorded to modified response evaluation criteria in solid tumors(m RECIST).The incidence of adverse reactions during treatment was recorded with reference to the common terminology criteria for adverse events(CTCAE)version 4.0.At the same time,follow-up and record the prognosis of the two groups of patients.Serum VEGF and MMP-2 levels were measured before treatment,after treatment and 3 months of follow-up.The short-term treatment effect,overall response rate(ORR),median survival time,and incidence of adverse reactions were compared between the two groups of patients.At the same time,the effects of the two treatments on serum VEGF and MMP-2 levels before treatment,after treatment and after 3 months of follow-up were compared.Results(1)According to m RECIST,the ORR of the experimental group reached 73.33%,and the ORR of the control group was 46.67%.The difference in ORR between the two groups was statistically significant(P =0.035).(2)The survival analysis of the two groups of patients showed that the median survival time in the experimental group was 16 months,and the median survival time in the control group was 8 months.There was a statistically significant difference in postoperative survival time between the two groups of patients(P =0.029).(3)There was no statistically significant difference in the incidence of adverse reactions after TACE treatment,such as gastrointestinal reactions(P=0.438),liver pain(P=0.598),fever(P=0.301),liver dysfunction(P=0.196),and renal dysfunction(P=0.448)during the two groups during treatment.The adverse reactions of apatinib in the experimental group were mainly hypertension(P=0.000),fatigue(P=0.000),hand-foot syndrome(P=0.000),diarrhea(P=0.000),proteinuria(P=0.000),The incidence of adverse events was significantly higher than the control group,the difference was statistically significant.(4)After treatment and at 3 months of follow-up,the serum VEGF level in the experimental group was significantly lower than before treatment(P=0.001)and the control group(P=0.000),the difference was statistically significant;After treatment and at 3 months of follow-up,the serum MMP-2 level in the experimental group was significantly lower than that before treatment(P=0.003)and the control group(P=0.002),the difference was statistically significant.Conclusion 1.The short-term effect of apatinib combined with TACE treatment is better than that of single TACE treatment,and it can appropriately prolong the survival time of patients with advanced HCC,which has a certain positive effect on delaying tumor progression.2.Apatinib will increase the incidence of adverse reactions in patients,but most of the adverse reactions are mild and can be relieved after drug reduction,short-term withdrawal or symptomatic treatment,without reducing the quality of life of patients.3.Apatinib combined with TACE treatment reduced the serum VEGF and MMP-2 levels in patients with advanced HCC and improved the short-term treatment effect.