目的 探讨卡瑞丽珠单抗（PD-1抑制剂）联合仑伐替尼和FOLFOX方案经肝动脉灌注化疗（HAIC）治疗中晚期肝癌的临床疗效和安全性。 方法 选取2021年1月至2023年1月桂林医学院第二附属医院收治的160例中晚期肝癌患者，按随机数字表法分为对照组和观察组，每组各80例。对照组给予肝动脉化疗栓塞（TACE）治疗，并且接受每日一次口服仑伐替尼治和卡瑞丽珠单抗静脉输注治疗，治疗周期为12周。观察组给予FOLFOX方案经HAIC化疗，并且接受每日一次口服仑伐替尼治和卡瑞丽珠单抗静脉输注治疗，治疗周期为12周。对患者进行定期随访复查，观察两组的临床疗效并采用mRECIST标准进行疗效评价。对两组患者进行了客观缓解率（ORR）、疾病控制率（DCR）、总体生存时间（OS）、无进展生存期（PFS）和不良反应发生情况的比较。 结果 观察组和对照组的客观缓解率和不良反应发生率之间无显著差异。然而，观察组在疾病控制率、总体生存时间和无进展生存期方面均优于对照组，这些差异有统计学意义（P < 0.05）。 结论 FOLFOX-HAIC化疗方案联合卡瑞丽珠单抗及仑伐替尼治疗中晚期肝癌患者安全有效，不会造成不良反应，且可以延长患者的OS和PFS，提高患者生存质量。

Objective To investigate the clinical efficacy and safety of nivolumab （PD-1 inhibitor） in combination with lenvatinib and FOLFOX regimen ［5-fluorouracil （5-FU）， oxaliplatin （L-OHP）， and calcium folinate （LV）］ in the treatment of intermediate and advanced hepatocellular carcinoma （HCC） via hepatic arterial infusion chemotherapy （HAIC）. Methods A total of 160 patients with intermediate and advanced HCC admitted to the Second Affiliated Hospital of Guilin Medical University from January 2021 to January 2023 were randomly divided into the control group and the observation group， with 80 patients in each group， using a random number table. The control group received once-daily oral lenvatinib and intravenous carrizumab infusions for 12 weeks as part of transcatheter arterial chemoembolization （TACE） therapy. The observation group was administered with FOLFOX regimen via HAIC chemotherapy， plus intravenous infusion of carrizumab for 12 weeks and once-daily oral lenvatinib. All the patients were followed up regularly. The clinical efficacy was evaluated using the mRECIST criteria. The objective response rate （ORR）， disease control rate （DCR）， overall survival （OS）， progression-free survival （PFS）， and incidence of adverse reactions were compared between the two groups. Results There were no significant differences in the objective response rate and incidence of adverse reactions between the groups. The disease control rate， overall survival， and progression-free survival in the observation group were significantly higher than those in the control group （P < 0.05）. Conclusions The FOLFOX-HAIC regimen in combination with nivolumab and lenvatinib is safe and effective for the treatment of intermediate and advanced HCC， without adverse reactions. It can prolong the overall survival and progression-free survival， and improve the patient′s quality of life.