Abstract: Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with lenvatinib in the treatment for intermediate-to-advanced hepatocellular carcinoma (HCC) in the elderly patients. Methods The clinical data of the elderly HCC patients treated at Nanjing First Hospital from June 2018 to August 2020 were collected. All patients were divided into TACE group (n=63) and TACE plus lenvatinib group (n=76) according to treatment methods. The tumor response, survival outcomes, and adverse events were compared between the two groups. Results The Objective response rate (ORR) and disease control rate (DCR) were significantly higher in TACE plus lenvatinib group than those in TACE group (P<0.001). The median progression-free survival (PFS) was 7.5 months in TACE group, compared with 12.5 months in TACE plus lenvatinib group (P<0.05). The median overall survival (OS) was 9.6 months in TACE group, compared with 15.8 months in TACE plus lenvatinib group (P<0.05). The adverse events during follow-up were grade I-II and effectively controlled with symptomatic treatment. Conclusions In the elderly patients with intermediate-to-advanced HCC, the combination of TACE and lenvatinib can significantly improve efficacy and prolong survival time, and is well-tolerated.

Key words: transarterial chemoembolization, hepatocellular carcinoma, lenvatinib