ABSTRACT
OBJECTIVE To observe the clinical efficacy and safety of camrelizumab combined with sorafenib in the treatment of advanced liver cancer. METHODS Sixty patients with advanced liver cancer who were treated in our hospital from March 2020 to November 2021 were selected as the study subjects， and then were randomly divided into study group and control group， with 30 cases in each group. The control group was treated with Sorafenib tosylate tablets orally （0.4 g，bid）， and the study group was additionally given Camrelizumab for injection intravenously （200 mg， every 3 weeks） based on the control group； for all patients， the treatment was stopped until disease progression or intolerable side effects occurred. The clinical efficacy， progression-free survival （PFS）， total survival （OS） and 1-year survival rate of the two groups were compared， and the incidence of adverse reactions in two groups， and immune-related adverse reactions in the study group during treatment were recorded. RESULTS The objective remission rate of the study group was significantly higher than the control group （36.7% vs. 13.3%， P＜0.05）， and the median OS and median PFS were significantly longer than the control group （OS： 12.6 months vs. 7.9 months； PFS： 8.2 months vs. 5.3 months， P＜0.05）. There was no significant difference in the 1-year survival rate and the incidence of elevated aspartate aminotransferase and alanine aminotransferase， rash or pruritus， anorexia， diarrhea， fatigue and hypertension between the two groups （P＞0.05）. The adverse events immune-related in the study group mainly included 21 cases of reactive capillary hyperplasia （70.0%）， 6 cases of hypothyroidism （20.0%）， and 1 case of immune-associated pneumonia （3.3%）， which were improved or tolerable after symptomatic treatment. CONCLUSIONS Camrelizumab combined with sorafenib in the treatment of advanced liver cancer can effectively control and delay the disease progression， prolong the survival period of patients， and the adverse reactions can be tolerated.
ABSTRACT
To investigate the assessed value of serum lactate dehydrogenase (LDH) and vascular endothelial growth factor (VEGF) for short-term efficacy of transcatheter arterial chemoembolization (TACE). Methods: Serum concentrations of LDH and VEGF from 70 patients with primary liver cancer on the 1st day before therapy and the 3rd, 7th, 14th, and 21st day after TACE ther-apy was determined. The benefit group includes complete remission, partial remission, and stable disease, while the invalid group in-cludes only disease progression. Results:The serum levels of LDH and VEGF in the invalid group were significantly higher than those in the benefit group on the 14th and 21st days after TACE (P<0.05). The percentage changes of the serum concentrations of LDH and VEGF in the invalid group were higher than those in the benefit group on the 21st day after TACE. Percentage changes on the 21st day after TACE were drawn into the ROC curve;the areas under the curve were 65.9%and 85.5%. The optimal cutoff points of LDH and VEGF, which correspond to the Youden index, were 0.272 and 0.745, respectively. Conclusion:The expression levels of VEGF and LDH can be used to assess the short-term efficacy of TACE. A lower expression level corresponds to short-term efficacy.
ABSTRACT
Objective To compare the clinical effect of hepatic artery perfusion of antibiotics with that of intravenous administration of antibiotics in treating pyogenic liver abscess which is unsuitable for puncture drainage management. Methods Between October 2010 and October 2013, a total of 32 cases with bacterial liver abscesses which were unsuitable for puncture drainage management were encountered at the Third Affiliated Hospital of Wenzhou Medical University. The patients were divided into group A (n = 15) and group B (n = 17). Hepatic arterial perfusion of antibiotics was carried out in the patients of group A, while intravenous administration of antibiotics was employed in the patients of group B. Percutaneous puncture drainage was adopted in the patients when their imaging examination showed liquefaction within the lesion. Results The hospitalization time, recovery time of body temperature, hemogram recovery time and liquefaction extent of the lesion in group A were much better than those in group B , and the differences were statistically significant (P < 0.05). Conclusion Hepatic arterial perfusion of antibiotics is an important and effective treatment for bacterial liver abscesses.