Evaluation of curative effect and analysis of factors influencing survival rate of unresectable advanced liver cancer treated with lenvatinib combined with TACE

doi:10.3877/cma.j.issn.2095-2015.2025.02.005

Abstract

Abstract:

Objective

To evaluate the efficacy of lenvatinib combined with transcatheter arterial chemoembolization （TACE） in the treatment of unresectable advanced liver cancer，and to analyze the risk factors affecting the survival rate of patients.

Methods

The clinical data of 160 patients with unresectable advanced liver cancer admitted to the Department of Oncology and Department of Intervention of our hospital from January 2023 to July 2023 were retrospectively analyzed. All patients received lenvatinib combined with TACE. The clinical efficacy of all patients after 8 weeks of treatment and the changes of alanine aminotransferase （ALT），aspartate aminotransferase （AST），total bilirubin （TBIL），alpha-fetoprotein（AFP），carcinoembryonic antigen （CEA），carbohydrate antigen 199 （CA199） were recorded，and the 12-month survival rate and progression-free survival （PFS） were recorded，the multivariate Logistic regression analysis was used to analyze the risk factors affecting the survival rate of patients.

Results

Among the 160 patients，the objective response rate （ORR） was 36.25% and the disease control rate （DCR） was 73.13%. ALT，AST，TBIL，AFP，CEA and CA199 after treatment were all lower than before treatment，with statistically significant differences （P＜0.05）. The follow-up analysis showed that 54 patients died and 106 survived，the 12-month survival rate was 63.75%，and PFS was 7.55 months. Multivariate Logistic regression analysis showed that Barcelona （BCLC） stage （OR： 5.801，95% CI： 2.345-14.347），portal vein cancer embolus （OR：6.328，95% CI： 2.509-15.961），peripheral blood neutrophil/lymphocyte ratio （NLR）（OR： 4.978，95% CI：2.350-10.545） and systemic immunoinflammatory Index （SII）（OR： 4.773，95% CI： 2.275-10.013） were the risk factors affecting the prognosis of patients （P＜0.05）.

Conclusion

Lenvatinib combined with TACE improves liver function in patients with unresectable advanced liver cancer，BCLC stage，portal vein cancer embolus，NLR and SII are risk factors affecting the survival rate of patients，and should be paid attention to clinically.

Key words: Primary liver cancer, Targeted therapy, Hepatic arterial chemoembolization, Lenvastinib, Prognosis, Risk factor

Ran Song, Yage Zheng. Evaluation of curative effect and analysis of factors influencing survival rate of unresectable advanced liver cancer treated with lenvatinib combined with TACE[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(02): 120-124.

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URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2025.02.005

https://zhxhbyyxzz.cma-cmc.com.cn/EN/Y2025/V15/I02/120

Figures/Tables 4

时间	例数	ALT（U/L）	AST（U/L）	TBIL（μmol/L）	AFP（μg/L）	CEA（ng/mL）	CA199（U/mL）
治疗前	160	68.21±7.83	64.57±6.50	23.71±3.02	464.82±45.73	35.47±5.60	263.73±35.61
治疗后	160	54.02±5.64	48.92±5.13	18.28±2.17	371.25±21.82	23.54±3.47	185.68±20.65
t 值		18.600	23.907	18.470	23.359	22.906	23.984
P 值		0.000	0.000	0.000	0.000	0.000	0.000

临床特征		死亡组（n=54）	生存组（n=106）	χ ² 值	P 值
性别［例（%）］	男	37（68.52）	66（62.26）	0.610	0.435
	女	17（31.48）	40（37.74）
年龄［例（%）］	≥60 岁	39（72.22）	64（60.38）	2.189	0.139
	＜60 岁	15（27.78）	42（39.62）
ECOG 评分［例（%）］	0 分	43（79.63）	92（86.79）	1.392	0.238
	1 分	11（20.37）	14（13.21）
BCLC 分期［例（%）］	B 期	23（42.59）	70（66.04）	8.079	0.004
	C 期	31（57.41）	36（33.96）
肿瘤直径［例（%）］	≥5 cm	35（64.81）	61（57.55）	0.787	0.375
	＜5 cm	19（35.19）	45（42.45）
Child-Pugh 分级［例（%）］	A 级	16（29.63）	33（31.13）	0.038	0.845
	B 级	38（70.37）	73（68.87）
门静脉癌栓［例（%）］	有	26（48.15）	26（24.53）	9.098	0.003
	无	28（51.85）	80（75.47）
CA199［例（%）］	≥27 U/mL	32（59.26）	57（53.77）	0.426	0.509
	＜27 U/mL	22（40.74）	49（46.23）
AFP［例（%）］	≥400 μg/L	30（55.56）	47（44.34）	1.803	0.179
	＜400 μg/L	24（44.44）	59（55.66）
NLR（ $\overset{ˉ}{x}$ ± s ）		3.37±0.58	2.26±0.41	14.010	0.000
SII（ $\overset{ˉ}{x}$ ± s ）		384.51±35.83	273.02±28.67	21.336	0.000

临床特征		死亡组（n=54）	生存组（n=106）	χ ² 值	P 值
性别［例（%）］	男	37（68.52）	66（62.26）	0.610	0.435
	女	17（31.48）	40（37.74）
年龄［例（%）］	≥60 岁	39（72.22）	64（60.38）	2.189	0.139
	＜60 岁	15（27.78）	42（39.62）
ECOG 评分［例（%）］	0 分	43（79.63）	92（86.79）	1.392	0.238
	1 分	11（20.37）	14（13.21）
BCLC 分期［例（%）］	B 期	23（42.59）	70（66.04）	8.079	0.004
	C 期	31（57.41）	36（33.96）
肿瘤直径［例（%）］	≥5 cm	35（64.81）	61（57.55）	0.787	0.375
	＜5 cm	19（35.19）	45（42.45）
Child-Pugh 分级［例（%）］	A 级	16（29.63）	33（31.13）	0.038	0.845
	B 级	38（70.37）	73（68.87）
门静脉癌栓［例（%）］	有	26（48.15）	26（24.53）	9.098	0.003
	无	28（51.85）	80（75.47）
CA199［例（%）］	≥27 U/mL	32（59.26）	57（53.77）	0.426	0.509
	＜27 U/mL	22（40.74）	49（46.23）
AFP［例（%）］	≥400 μg/L	30（55.56）	47（44.34）	1.803	0.179
	＜400 μg/L	24（44.44）	59（55.66）
NLR（ $\overset{ˉ}{x}$ ± s ）		3.37±0.58	2.26±0.41	14.010	0.000
SII（ $\overset{ˉ}{x}$ ± s ）		384.51±35.83	273.02±28.67	21.336	0.000

因素	β	SE	Wald 值	OR	95% CI
BCLC 分期	1.758	0.462	14.480	5.801	2.345～14.347
门静脉癌栓	1.845	0.472	15.279	6.328	2.509～15.961
NLR	1.605	0.383	17.561	4.978	2.350～10.545
SII	1.563	0.378	17.098	4.773	2.275～10.013

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