Page 7 - 南京医科大学自然版

第46卷第8期 南京医科大学学报（自然科学版）
2026年8月 Journal of Nanjing Medical University（Natural Sciences） ·1113 ·

·专题研究：肿瘤·

靶向联合免疫方案结合或不结合 TACE/放疗在中晚期肝细胞

癌转化治疗中的应用

兰 欣，韩国勇，吴金道 *

南京医科大学第一附属医院肝胆中心，江苏 南京 210029

［摘 要］ 目的：评估靶向联合免疫方案结合或不结合经导管动脉化疗栓塞术（transcatheter arterial chemoembolization，
TACE）/放疗对初始不可切除中晚期肝细胞癌（hepatocellular carcinoma，HCC）的有效性及安全性。方法：回顾性分析20例巴塞
罗那临床肝癌（Barcelona clinic liver cancer，BCLC）分期B/C期HCC患者资料，所有患者均接受靶向联合免疫治疗。19例联合
TACE，其中 4 例加用放疗。评价指标包括客观缓解率（objective response rate，ORR）、显微镜下切缘阴性（microscopic margin⁃
negative，R0）率及安全性。结果：总体ORR为55%，疾病控制率为85%。4例（20%）成功实施R0切除，术后病理显示2例达到
主要病理缓解。3 级不良事件发生率为 20%，多为免疫相关性肝损伤，安全性可控。全组中位随访 18.3 个月。4 例手术患者
中，3例在术后12个月无复发生存。结论：以靶向联合免疫为核心的多模式方案对中晚期HCC具有显著的降期能力，R0切除
率达20%，病理缓解显著且安全性可控。
［关键词］ 肝细胞癌；转化治疗；靶向联合免疫；经导管动脉化疗拴塞术；放疗
［中图分类号］ R735.7 ［文献标志码］ A ［文章编号］ 1007⁃4368（2026）08⁃1113⁃09
doi：10.7655/NYDXBNSN260532

Application of targeted immunotherapy combined with or without TACE/radiotherapy in
the conversion therapy for intermediate⁃to⁃ advanced hepatocellular carcinoma

LAN Xin，HAN Guoyong，WU Jindao *
Hepatobiliary Center，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：To evaluate the efficacy and safety of targeted therapy plus immunotherapy ± transcatheter arterial
chemoembolization（TACE）/radiotherapy for conversion therapy in initially unresectable intermediate ⁃ to ⁃ advanced hepatocellular
carcinoma（HCC）. Methods：We retrospectively analyzed 20 patients with Barcelona clinic liver cancer（BCLC）stage B/C HCC treated
with targeted therapy and immunotherapy；19 received concurrent TACE，and 4 received radiotherapy among them. The evaluation
indicators include objective response rate（ORR），microscopic margin⁃negative（R0）resection rate and safety. Results：The overall
ORR and the disease control rate were 55% and 85%，respectively. Four patients（20%）successfully underwent R0 resection，with 2
achieving major pathological response. The incidence of grade ≥3 adverse events was 20%，primarily immune⁃related liver injury. At a
median follow⁃up of 18.3 months，3 of the 4 resected patients remained recurrence⁃free 12 months post⁃surgery. Conclusion：The
multimodal approach centered on targeted combined immunotherapy has a significant ability to downstage advanced HCC. The R0
resection rate is 20%，and the pathological remission is remarkable with controllable safety.
［Key words］ hepatocellular carcinoma；conversion therapy；targeted therapy combined with immunotherapy；transcatheter arterial
chemoembolization；radiotherapy
［J Nanjing Med Univ，2026，46（08）：1113⁃1121］

［基金项目］ 国家自然科学基金（81972768）
通信作者（Corresponding author），E⁃mail：wujindao@njmu.edu.cn（ORCID：0000⁃0002⁃2317⁃6565）
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