载药微球在原发性肝癌TACE治疗中疗效及安全性分析  

Transcatheter arterial chemoembolization with drug-eluting beads in the treatment of primary hepatocellular carcinoma: analysis of its curative effect and safety

作　　者：李梅 宋娟荣 翟鹏涛 穆旭东 姚乐[2] LI Mei;SONG Juanrong;ZHAI Pengtao;MU Xudong;YAO Le(Department of Minimally-Invasive Intervention,Shaanxi Provincial Cancer Hospital,Xi’an,Shaanxi Province 710061,China)

机构地区：[1]陕西省肿瘤医院微创介入科,西安710061 [2]陕西省榆林市第一医院感染科

出　　处：《介入放射学杂志》2021年第2期186-190,共5页Journal of Interventional Radiology

摘　　要：目的探讨在TACE治疗原发性肝癌中载药微球(DEB)的应用的近期疗效及安全性。方法回顾性分析原发性肝癌101例,按照所用栓塞剂不同,分为DEB-TACE组(49例)和cTACE组(52例),DEB-TACE组应用CalliSphere载药微球进行TACE治疗。cTACE组应用罂粟乙碘油行TACE治疗,比较两组患者近期疗效,甲胎蛋白、肝功能变化和术后并发症。结果术后第3天两组ALB均较术前降低,差异有统计学意义(P<0.05),ALT、AST、TBIL、DBI均较术前增高,差异有统计学意义(P<0.05)。术后1个月,DEB-TACE组和cTACE组客观缓解率分别为69.4%与55.8%,疾病控制率分别为93.9%与88.5%。术后3个月,两组客观缓解率分别为59.2%与42.3%,疾病控制率分别为87.8%与76.9%,差异均无统计学意义(P>0.05)。术后6个月,两组客观缓解率分别为53.1%与30.8%,差异有统计学意义(P<0.05),疾病控制率分别为79.6%与69.2%,差异无统计学意义(P>0.05)。术后6个月AFP≥200 ng/mL,DEB-TACE组为25.8%,cTACE组为56.3%,差异有统计学意义(P<0.05)。术后两组均出现轻度的栓塞后综合征,经对症治疗后症状消失,两组分别相比,差异均无统计学意义(P>0.05),未见肾衰竭、感染、骨髓抑制等严重并发症。结论DEB-TACE治疗原发性肝癌近期疗效肯定,安全性好,值得临床推广。Objective To investigate the short-term efficacy and safety of drug-eluting beads transcatheter arterial chemoembolization(DEB-TACE) in treating primary hepatocellular carcinoma(PHC). Methods The clinical data of a total of 101 PHC patients were retrospectively analyzed. According to the embolic agents used, the patients were divided into DEB-TACE group(using CalliSphere drug-eluting microspheres, n=49)and cTACE group(using conventional poppy ethiodized oil, n=52). The short-term efficacy, alpha-fetoprotein(AFP) level, liver function and postoperative complications were compared between the two groups.Results Three days after treatment, the ALB level in both groups was obviously lower than preoperative one, the difference was statistically significant(P<0.05), while the levels of ALT, AST, TBIL and DBI were strikingly higher than preoperative ones, the differences were statistically significant(P<0.05). One month after treatment, in DEB-TACE group and cTACE group the objective remission rate was 69.4% and 55.8%respectively, the disease control rate was 93.9% and 88.5% respectively. Threemonths after treatment, in DEB-TACE group and cTACE group the objective remission rate was 59.2% and 42.3% respectively, the disease control rate was 87.8% and 76.9% respectively,the differences between the two groups were not statistically significant(P>0.05). Six months after treatment, in DEB-TACE group and cTACE group the objective remission rate was 53.1% and 30.8% respectively(P<0.05),the disease control rate was 79.6% and 69.2%respectively(P>0.05), the proportion of patients with AFP≥200 ng/mL was 25.8% and 56.3% respectively(P<0.05). Mild post-embolization syndrome was observed in both groups(P>0.05), the symptoms of which disappeared after symptomatic therapy. No severe complications such as renal failure, infection and bone marrow suppression occurred. Conclusion For the treatment of PHC, DEB-TACE has satisfactory short-term curative effect and reliable safety. Therefore, this therapy is worthy of clinical promotion.

关 键 词：载药微球 罂粟乙碘油 原发性肝癌 肝动脉化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]