载药微球经动脉化疗栓塞治疗老年消化道癌的疗效  

The efficacy of drug-eluting bead transarterial chemoembolization for the treatment of digestive tract cancer in the elderly

作　　者：李臻[1] 石洋 魏亚雯 葛乃建 任志刚[4] 纪坤 李鑫[1] 詹鹏超 刘俊英[5] 韩新巍[1] LI Zhen;SHI Yang;WEI Yawen;GE Naijian;REN Zhigang;JI Kun;LI Xin;ZHAN Pengchao;LIU Junying;HAN Xinwei(Department of Interventional Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Anesthesiology,Dingxi Hospital of Traditional Chinese Medicine,Dingxi,Gansu Province 743000,China;Department of Interventional Radiology,Eastern Hepatobiliary Surgery Hospital of Naval Medical University,Shanghai 200438,China;Department of Infectious Disease,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Liver Disease Institute of Zhoukou Central Hospital,Zhoukou,He’nan Province 477150,China)

机构地区：[1]郑州大学第一附属医院放射介入科,河南郑州450052 [2]定西市中医院麻醉科,甘肃定西743000 [3]海军军医大学东方肝胆外科医院放射介入科,上海200438 [4]郑州大学第一附属医院感染科,河南郑州450052 [5]周口市中心医院肝病研究所,河南周口477150

出　　处：《实用放射学杂志》2021年第7期1173-1177,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目(U1904143).

摘　　要：目的 探讨载药微球经动脉化疗栓塞(DEB-TACE)治疗老年消化道癌(DTC)的初步疗效及安全性、可行性.方法 回顾性分析接受DEB-TACE治疗的65岁及以上15例DTC患者的临床资料,术前均行病理活检,病理类型为腺癌.DEB-TACE术后1、3、6、12个月复查CT或MRI,参照改良实体瘤疗效评价标准(mRECIST)部分内容评价疗效.记录无进展生存期(PFS)、总生存期(OS),观察有无严重不良事件.结果 15例患者DEB-TACE手术顺利,共35人次,均未出现严重并发症.中位随访时间为10个月(3~20个月),截止随访日期,15例患者中完全缓解(CR)1例(6.7%),部分缓解(PR)7例(46.7%),疾病稳定(SD)1例(6.7%),疾病进展(PD)6例(40.0%);术后1个月、6个月客观缓解率(ORR)和疾病控制率(DCR)分别为73.3%和100.0%、57.1%和64.3%,6个月OS率和PFS率分别为57.1%(8/14)和42.9%(6/14),中位无进展生存期(mPFS)为10个月(3~20个月).患者术后有不同程度的不良反应,对症处理后均缓解.随访期间血常规、肝肾功能、凝血功能等血生化指标均无明显差异(P>0.05).结论 DEB-TACE可有效控制老年DTC的肿瘤进展、减轻瘤负荷,技术安全、可行,近期疗效确切.Objective To investigate the preliminary efficacy,safety and feasibility of drug eluting bead transarterial chemoembolization(DEB-TACE)in the treatment of elderly patients with digestive tract cancer(DTC).Methods The clinical data of 15 patients with DTC aged 65 and above who accepted DEB-TACE treatment were analyzed retrospectively,and the result of preoperative pathological biopsy was adenocarcinoma.1,3,6 and 12-month postoperative CT or MRI was performed to evaluate the curative efficacy according to modified response evaluation criteria in solid tumors(mRECIST)standard.The possible event of serious adverse,progression-free survival(PFS)and overall survival(OS)was recorded.Results DEB-TACE was performed successfully in 15 patients,with a total of 35 person times,and no serious complications occurred.The median follow-up period was 10 months(3-20 months).Up to the last day of follow-up,1 patient(6.7%)had complete response(CR),7 patients(46.7%)had partial response(PR),1 patient(6.7%)had stable disease(SD)and 6 patients(40.0%)had progressive disease(PD).The objective response rate(ORR)and disease control rate(DCR)at 1 and 6 months after operation were 73.3% and 100%,57.1%and 64.3%,respectively.The 6-month OS and PFS rates were 57.1%(8/14)and 42.9%(6/14),respectively.The median PFS(mPFS)was 10 months(3-20 months).The patients had different degrees of adverse reactions after operation,and got relieved after symptomatic treatment.There was no significant difference in blood routine,liver and kidney function,blood coagulation and other blood biochemical indexes during the follow up period(P>0.05).Conclusion DEB-TACE can effectively control the tumor progression and reduce the tumor load of elderly patients with DTC.It is safe,feasible and has a definite short-term effect.

关 键 词：消化道癌 载药微球 经动脉化疗栓塞 介入治疗 

分 类 号：R735[医药卫生—肿瘤] R815[医药卫生—临床医学]