Clinical effect and safety of transarterial chemoembolization combined with apatinib in treatment of advanced primary liver cancer

Objective To investigate the clinical effect and safety of transarterial chemoembolization (TACE) combined with apatinib versus TACE alone in the treatment of advanced primary liver cancer (PLC) .Methods A retrospective analysis was performed for the clinical data of 56 patients with PLC who were admitted to Xijing Hospital of Air Force Medical University from March to August, 2015, and according to therapies, these patients were divided into observation group and control group, with 28 patients in each group.The patients in the observation group were given TACE combined with apatinib, and those in the control group were given TACE alone.The two groups were compared in terms of objective response rate (ORR) at 1, 3, 6, and 12 months after treatment, progression-free survival, and incidence rates of adverse reactions.The two-independent-samples t test was used for comparison of continuous data between groups; the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to analyze median progression-free survival and plot survival curves, and the log-rank test was used for survival difference analysis between the two groups.Results There was no significant difference in ORR at 1 and 3 months after treatment between the two groups (χ2= 0.312 and 2.450, P = 0.386 and 0.118) , while there was a significant difference in ORR at 6 and 12 months after treatment (χ2= 9.458 and 13.065, P = 0.002 and P < 0.001) .There was also a significant difference in progression-free survival between the two groups (χ2= 9.083, P = 0.006) .Compared with the control group, the observation group had significantly higher incidence rates of apatinib-related adverse reactions, such as hypertension, hand-foot syndrome, proteinuria, and diarrhea (χ2= 17.500, 16.095, 15.273, and 5.256, all P < 0.001) , and these adverse reactions were relieved after the symptomatic treatment.Conclusion Compared with TACE alone, TACE combined with apatinib has a better long-term effect and safety in the treatment of advanced PLC.