Aim: Transarterial chemoembolization (TACE) combined with lenvatinib, employing a 4-day lenvatinib administration followed by TACE without an interval (short-term LEN-TACE), was performed for hepatocellular carcinoma (HCC). The aim was to assess tumor hemodynamics following the 4-day lenvatinib and to evaluate the treatment outcomes after the short-term LEN-TACE. Methods: 25 unresectable HCC patients received this combined therapy. Lenvatinib (4–12 mg) was administrated for 4 days prior to TACE. Perfusion CT scans were obtained before and after the lenvatinib administration. Either cTACE (76%) or DEB-TACE (24%) were performed. Results: intra-tumor blood flow significantly decreased after the 4-day lenvatinib (p< 0.05). The TACE procedure was successful with no severe adverse events in all patients. The overall complete response (CR) rate was 75% (cTACE 84%, DEB-TACE 40%). The lipiodol-washout ratio between 1 week and 4 months after cTACE correlated with the arterial flow reduction ratio by lenvatinib prior to TACE (r= −0.55). The 12-month progression-free survival (PFS) rate was 75.0%. Conclusions: The short-term LEN-TACE is feasible and safe, demonstrating promising outcomes with a high CR ratio, contributing to lipiodol retention in the tumor after cTACE, and extended PFS. To confirm the advantages of this treatment protocol, a prospective clinical trial is mandatory.
目的：本研究对肝细胞癌（HCC）患者实施经动脉化疗栓塞（TACE）联合仑伐替尼治疗，采用先给予4天仑伐替尼后立即行TACE（短期LEN-TACE）的治疗方案。旨在评估4天仑伐替尼治疗后的肿瘤血流动力学变化，并评价短期LEN-TACE的治疗效果。方法：25例不可切除HCC患者接受该联合治疗。TACE前连续4天给予仑伐替尼（4-12 mg）。在仑伐替尼给药前后分别进行灌注CT扫描。分别实施cTACE（76%）或DEB-TACE（24%）。结果：4天仑伐替尼治疗后肿瘤内血流量显著降低（p<0.05）。所有患者TACE操作均成功完成，无严重不良事件发生。总体完全缓解（CR）率为75%（cTACE组84%，DEB-TACE组40%）。cTACE后1周至4个月间的碘油清除率与TACE前仑伐替尼引起的动脉血流减少率呈负相关（r=-0.55）。12个月无进展生存（PFS）率为75.0%。结论：短期LEN-TACE方案可行且安全，展现出良好的治疗效果，包括高CR率、有助于cTACE后碘油在肿瘤内滞留，并延长PFS。为确认该治疗方案的优势，有必要开展前瞻性临床试验。
肿瘤(癌症)患者之家