Objective: To observe the safety and efficacy of lenvatinib for the treatment of medium-advanced hepatocellular carcinoma. Methods: A total of 36 patients with medium-advanced hepatocellular carcinoma from the First Medical Center of the Chinese PLA General Hospital were retrospectively analyzed from January 2018 to May 2019. All patients had shown tumor progression after at least 2 sessions of TACE. The patients were consisted of 30 males and 6 females with age range of 35 to 76 (54±10) years. Patients received orally administered lenvatinib at a dose of 12 mg once daily for patients ≥ 60 kg and 8 mg once daily for patients<60 kg. According to modified RECIST criteria the tumor response, disease control rate, overall survival and progression free survival were evaluated once every 6-8 weeks. The adverse events were recorded. Results: No patient was in complete response, 2 cases (5.7%) in partial response, and 5 cases (14.3%) in stable disease, respectively. Disease control rate was 20.0% (7/35), the overall survival was 11.5 months, and the progression free survival was 5.3 months. The overall incidence of adverse events was 66.7% (24/36). The most frequent adverse events were hypertension, proteinuria, hand-foot skin reaction and abdominal distension. Conclusion: Lenvatinib can extend the overall survival in a percentage of medium-advanced hepatocellular carcinoma patients who were unresectable and refractory to TACE. Although the incidence of adverse events is high, most of them are mild and reversible.
目的： 观察仑伐替尼治疗经肝动脉化疗栓塞术（TACE）治疗无效的中晚期原发性肝细胞癌患者的安全性及有效性。 方法： 回顾性分析2018年1月至2019年5月解放军总医院第一医学中心介入放射科收治的不可切除且对TACE无效（间隔4~6周、两次TACE后仍呈肿瘤进展）的中晚期原发性肝细胞癌患者36例，男30例、女6例，年龄35~76（54±10）岁。所有患者均口服仑伐替尼（体质量≥60 kg者12 mg/d；体质量<60 kg者8 mg/d）后6~8周以改良实体瘤疗效评价标准（mRECIST）评价疗效，包括疾病控制率、总生存期及无进展生存期，并记录药物相关不良反应等，此后每8周评估一次。 结果： 具有完整的随访资料者35例，无完全缓解病例，部分缓解2例（5.7%），稳定5例（14.3%），疾病控制率20.0%（7/35），总生存期11.5个月，无进展生存期5.3个月。24例（66.7%）患者发生不良反应，最常见的不良反应有高血压、蛋白尿、腹胀等，因不能耐受停用者1例（2.8%）、减量者5例（13.9%）。 结论： 仑伐替尼对部分不可切除且对TACE无效的中晚期肝细胞癌患者有效，能延长总生存期，虽然药物不良反应发生率较高，但多较轻且为可逆。.
Keywords: Carcinoma, hepatocellular; Lenvatinib; Tyrosine kinase inhibitor.