载药微球与传统C-TACE在治疗乏血供型原发性肝癌中的临床疗效对比  

Calli spheres drug-eluting beads versus conventional transarterial chemoembolization in the therapy of hypovascular hepatocellular carcinoma

作　　者：张大闯 马富权 马富平 晁延军 李志路 刘宁 代晓强 ZHANG Da-chuang;MA Fu-quan;MA Fu-ping;CHAO Yan-jun;LI Zhi-lu;LIU Ning;DAI Xiao-qiang(Department of General Surgery, Xianyang central Hospital, Xianyang 712000, Shaanxi, China;Department of Gastroenterology, First Affiliated Hospital of Xi′an Jiaotong University, Xi′an710006, China;Department of Interventional Oncology Radiotherapy, Xianyang central Hospital, Xianyang 712000, Shaanxi, China;Department of Medical Oncology, Xianyang central Hospital, Xianyang 712000, Shaanxi, China)

机构地区：[1]咸阳中心医院普外科,712000 [2]西安交通大学第一附属医院消化内科,710006 [3]咸阳中心医院肿瘤放疗介入科,712000 [4]咸阳中心医院肿瘤内科,712000

出　　处：《现代消化及介入诊疗》2021年第6期689-692,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：陕西省重点研发计划项目(2019SF-195)。

摘　　要：目的评价载药微球经动脉化疗栓塞术(DEB-TACE)和碘化油经动脉化疗栓塞术(C-TACE)治疗乏血供型原发性肝细胞癌的临床疗效。方法回顾性分析2017年7月至2020年1月咸阳中心医院行TACE手术的63例乏血供型原发性肝癌患者资料,分为DEB-TACE治疗组28例和C-TACE治疗组35例。已病理明确诊断原发性肝癌并由两位资深放射科医师根据术前术中影像学内容独立诊断为乏血供型原发性肝癌,分别比较DEB-TACE与C-TACE治疗乏血供型原发性肝癌的术后6月的肿瘤反应率、累积无进展生存期、总生存期与术后并发症。结果DEB-TACE治疗与传统C-TACE治疗组间在客观缓解率(78.6%vs 40%,P=0.002),无进展生存期(HR=0.535,95%CI:0.304~0.940,P=0.018)以及总体生存期(HR=0.384,95%CI:0.197~0.747,P=0.002),差异有统计学意义。两组间在急性肝功能障碍、发热、呕吐、中重度腹痛与肝脓肿方面差异均无统计学意义(P>0.05)。结论对于治疗乏血供型原发性肝癌,DEB-TACE相对C-TACE治疗在客观缓解率、无进展生存期和总生存期均更有优势,且未明显增加治疗相关的不良反应。Objective To compare clinical efficacy and safety between Calli spheres drug-eluting beads trans-arterial chemoembolization(DEB-TACE)and conventional TACE(C-TACE)in the therapy of hypovascular hepatocellular carcinoma(HCC).Methods The hypovascular HCC patients who underwent TACE from July 2017 to January 2020 were reviewed and analyzed in the study.Finally,63 patients with hypovascular HCC,involving 28 cases in the C-TACE group and 35 cases in the DEB-TACE group,were included in this study.The hypovascular HCC was diagnosed by pathology and independently performed by two senior radiologists according to the patients′imaging.In the study we compared tumor response,progression-free survival(PFS),overall survival(OS)and adverse events(AEs)between DEB-TACE and C-TACE.Results Patients in DEB-TACE group had better ORR(78.6%vs 40%,P=0.002),PFS(HR=0.535,95%CI:0.304~0.940,P=0.018)and OS(HR=0.384,95%CI:0.197~0.747,P=0.002)compared to patients in C-TACE group.There were no significant differences in acute liver dysfunction,fever,vomiting,moderate to severe abdominal pain and liver abscess between the two groups(P>0.05).Conclusion Compared to C-TACE,DEB-TACE showed better ORR and improved PFS and OS for hypovascular HCC with patients.While DEB-TACE had the similar AEs with C-TACE.

关 键 词：乏血供型原发性肝癌 载药微球 碘油栓塞 临床疗效 

分 类 号：R735.7[医药卫生—肿瘤] R812[医药卫生—临床医学]