Efficacy and safety of paclitaxel combined with oxaliplatin in the treatment of advanced primary hepatocellular carcinoma

Primary liver cancer (PLC) often presents with subtle early symptoms, leading to most diagnoses at advanced stages, which negatively impacts treatment outcomes. This study evaluated the efficacy and safety of albumin-bound paclitaxel (nab-PTX) combined with Oxaliplatin (OXA) in the treatment of advanced PLC patients without surgical indications. A total of 126 patients with advanced PLC were divided into two treatment groups: the nab-PTX/OXA group (n=66) and the sorafenib (Sor)/OXA group (n=60), with a treatment cycle of 21 days. Clinical response rates, sleep quality (SQ), quality of life (QoL), prognosis, and adverse reactions were compared between the two groups. The results indicated that, after treatment, the nab-PTX/OXA group demonstrated significantly higher objective response rate, sleep quality (PSQI score), and QoL (SF-36 score) compared to the Sor/OXA group (all <i>P</i><0.05). Both groups demonstrated significant increases in Cluster of Differentiation 3-positive (CD3+) and CD4+ cell levels at Day 21 compared to Day 0 (<i>P</i><0.05), with a greater increase observed in the nab-PTX/OXA group (<i>P</i><0.05). Conversely, CD8+ cell levels were significantly decreased at Day 21 compared to Day 0 in both groups (<i>P</i><0.05), with a more pronounced decrease in the nab-PTX/OXA group (<i>P</i><0.05). Additionally, the CD4+/CD8+ ratio was significantly elevated at Day 21 compared to Day 0 in both groups (<i>P</i><0.05), with a greater increase observed in the Sor/OXA group (<i>P</i><0.05). Furthermore, the overall survival (OS) and progression-free survival (PFS) in the nab-PTX/OXA group were significantly longer than those in the Sor/OXA group (<i>P</i><0.05). In the nab-PTX/OXA group, the incidence of abdominal pain and diarrhea, grade III-IV leukopenia, thrombocytopenia, and liver and kidney dysfunction was significantly lower than that in the Sor/OXA group (<i>P</i><0.05). In short, PTX combined with OXA demonstrated favorable efficacy in treating advanced PLC. This regimen not only improved SQ and QoL but also prolonged survival.