目的： 旨在比较抗血管生成免疫治疗联合肝动脉灌注化疗（hepatic artery infusion chemotherapy, HAIC）与联合肝动脉化疗栓塞（transcatheter arterial chemoembolization, TACE）治疗肝细胞癌的有效性和安全性。方法： 回顾性分析天津医科大学肿瘤医院2019年1月至2020年12月收治93例肝细胞癌病人,B期18例,C期75例。男74例,女19例,中位年龄57（27~78）岁。50例行抗血管生成免疫联合TACE（TACE组）治疗,43例行抗血管生成免疫联合HAIC（HAIC组）治疗。采用实体肿瘤疗效评价标准RECIST1.1评估疗效。主要观察终点为客观反应率和疾病控制率,次要观察终点为中位无进展生存期及中位总生存期。结果： HAIC组客观反应率和疾病控制率显著高于TACE组（客观反应率：72.09%比44.00%,P=0.006;疾病控制率：88.37%比60.00%,P=0.002）。 HAIC组及TACE组的中位随访时间分别为12.13个月及11.95个月。截至随访,TACE组中位无进展生存期11.83个月（95%CI：4.36~19.31个月）,中位总生存期17.93个月（95%CI：11.80~24.06个月）,而HAIC组均未到达中位无进展生存期和总生存期。两组无进展生存期及总生存期差异有统计学意义（P=0.017,P=0.007）。结论： 针对进展期肝细胞癌,抗血管生成免疫联合HAIC相比联合TACE在疾病控制和生存上获益更大,不良反应相对可控,安全性好。

Objective To compare hepatic artery infusion chemotherapy (HAIC) with transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma combined with both anti-angiogenesis and immunotherapy for effectiveness and safety. Methods Ninety-three patients with hepatocellular carcinoma including stage B 18 cases and stage C 75 cases, and 74 males, 19 females with a median age of 57 (27-78) in Tianjin Medical University Cancer Hospital from January 2019 to December 2020 were studied retrospectively. In the treatment combined with anti-angiogenesis and immunotherapy, 50 cases received TACE and 43 cases received HAIC. Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 was used to evaluate the efficacy of treatment. The primary endpoints were both objective response rate (ORR) and disease control rate (DCR), and the secondary endpoints both median progression free survival (mPFS) and median overall survival (mOS). Results Both ORR (72.09% vs. 44.00%, P=0.006) and DCR (88.37% vs. 60.00%, P=0.002) were significantly more in HAIC group than in TACE group. The median follow-up duration was 12.13 months in HAIC group and 11.95 months in TACE group. mPFS in TACE group was 11.83 months (95%CI: 4.36-19.31 months) with mOS 17.93 months (95%CI: 11.80-24.06 months). Both mPFS and mOS did not reach in HAIC group. There were significant differences in PFS and OS between two groups (P=0.017; P=0.007). Conclusions The patients with advanced hepatocellular carcinoma would benefit from HAIC combined with both anti-angiogenesis and immunotherapy in disease control and survival with less side effects and better safety when compared with TACE combination treatment.