目的 探讨贝伐珠单抗联合雷替曲塞治疗不可切除肝细胞癌的疗效及对不良反应和生存率影响。 方法 回顾性分析本院2020年2月至2022年6月肿瘤科收治的71例不可切除肝细胞癌患者，其中采用雷替曲塞治疗35例设为对照组，采用贝伐珠单抗联合雷替曲塞治疗36例设为观察组，所有患者均接受经导管肝动脉化疗栓塞术（TACE）治疗。治疗1个月后，评估两组短期治疗效果，观察两组不良反应情况；同时行随诊复查，记录两组无进展生存期（PFS）和总生存期（OS）。 结果 治疗1个月后，对照组疾病控制率（DCR）为74.29%，客观缓解率（ORR）为45.71%；观察组DCR为83.33%，ORR为55.56%；两组近期疗效比较差异无统计学意义（P > 0.05）。观察组治疗后血管内皮生长因子（VEGF）水平显著低于对照组（P < 0.05）。治疗后18个月随访，OS曲线显示：观察组OS为50.00%，对照组OS为31.40%；PFS曲线显示：观察组PFS为43.33%，对照组PFS为26.92%；利用Log-rank检验，两组OS差异有统计学意义（χ2 = 4.381，P = 0.036），两组PFS差异无统计学意义（χ2 = 3.264，P = 0.071）。两组不良反应对比差异无统计学意义（P > 0.05）。 结论 贝伐珠单抗联合雷替曲塞可减少肿瘤新生血管生成，持续抑制肿瘤生长与扩散，延长患者生存时间，不会增加药物不良反应。

Objective To investigate the efficacy of bevacizumab combined with raltitrexed in the treatment of unresectable hepatocellular carcinoma （HCC） and its effect on adverse reactions and survival rate. Methods A retrospective analysis was performed on 71 patients with unresectable hepatocellular carcinoma admitted to the oncology department of our hospital from February 2020 to June 2022. Among them， 35 cases were treated with raltitrexed as control group， and 36 cases were treated with bevacizumab combined with raltitrexed as observation group. All patients received transcatheter arterial chemoembolization （TACE）. After 1 month of treatment， the short-term treatment effect of the two groups was evaluated. The adverse reactions of the two groups were observed. Follow-up review was performed to record progression free survival （PFS） and overall survival（OS） in both groups. Results After 1 month of treatment， the disease control rate（DCR） and objective response rate（ORR） of control group were 74.29% and 45.71% respectively. The DCR and ORR of observation group were 83.33% and 55.56% respectively. There was no significant difference in short-term efficacy between the two groups （P > 0.05）. Following treatment， the vascular endothelial growth factor （VEGF）level in the observation group was considerably lower than in the control group （P < 0.05）. After treatment， 18 months of follow-up， OS curve showed： observation group OS was 50.00%， control group OS was 31.40%； PFS curve showed： observation group PFS was 43.33%， control group PFS was 26.92%. Using the Log-rank test， between the two groups， there was a statistically significant difference in OS （χ ² = 4.381， P = 0.036）， although there was no statistically significant difference in PFS between the two groups （χ ² = 3.264， P = 0.071）. There was no significant difference in adverse reactions between the two groups （P > 0.05）. Conclusion Bevacizumab combined with raltitrexed can reduce tumor neovascularization， inhibit tumor growth and spread， prolong the survival time of patients， and do not increase adverse drug reactions.