对比DEB-TACE与cTACE治疗不可切除的肝内胆管细胞癌的有效性及安全性  

The efficacy and safety of DEB-TACE compared with cTACE in the treatment of unresectable intrahepatic cholangiocarcinoma

作　　者：何海涛 刘尚大 韦广旭 许康祥 周鹏程 HE Hai-tao;LIU Shang-da;WEI Guang-xu;XU Kang-xiang;ZHOU Peng-cheng(Department of Radiology,Huai-an Medical District of Eastern Theater General Hospital,Jiangsu 223001,China;Department of Radiology,Huai’an No.82 Hospital,Jiangsu 223001,China;Department of Intervention,First Affiliated Hospital of Navy Military Medical University,Shanghai 200433,China)

机构地区：[1]东部战区总医院淮安医疗区影像科,江苏淮安223001 [2]淮安第八二医院影像科 [3]海军军医大学第一附属医院介入治疗科

出　　处：《肝脏》2022年第12期1292-1295,1308,共5页Chinese Hepatology

摘　　要：目的比较载药微球的经动脉化疗栓塞术(DEB-TACE)与传统的经动脉化疗栓塞术(cTACE)治疗不可切除的肝内胆管细胞癌(ICC)的有效性及安全性。方法选择2016年5月1日至2021年5月1日海军军医大学第一附属医院收治的ICC患者35例,其中17例接受DEB-TACE治疗,18例接受cTACE治疗。术后4~8周根据实体瘤疗效评估标准(RECIST)进行评估,并随访患者的生存情况。记录术后两组患者的不良事件并进行对比,疼痛程度采用视觉模拟评分(VAS)评估,呕吐及发热的程度则根据CTCAE 4.0版评价。比较患者术前、术后3 d患者的肝功能。结果DEB-TACE组患者的整体肿瘤客观反应率(ORR)高于cTACE组(58.8%比16.7%),差异有统计学意义(P=0.012)。DEB-TACE组患者的中位生存期为14(9,24)个月,cTACE组为12(8,24)个月,差异无统计学意义(P=0.697)。术后两组患者均未出现严重不良事件,但DEB-TACE组患者的栓塞后综合征发生率高于cTACE组(94.1%比55.6%),差异有统计学意义(P=0.026),以腹痛为著(94.1%比44.4%),差异有统计学意义(P=0.002),两组患者术后均出现不同程度的肝功能损伤,差异无统计学意义(P>0.05)。结论DEB-TACE治疗无远处转移的不可切除的ICC安全有效,短期疗效优于cTACE。Objective To compare the efficacy and safety of transarterial chemoembolization using drug-eluting bead transarterial chemoembolization(DEB-TACE)and traditional transarterial chemoembolization(cTACE)in the treatment of unresectable intrahepatic cholangiocarcinoma(ICC).Methods From May 1,2016 to May 1,2021,thirty five patients with ICC in our hospital were retrospectively analyzed.Among them,17 patients received DEB-TACE and 18 patients received cTACE.After 4 to 8 weeks,the patients were evaluated according to the solid tumor efficacy evaluation criteria(RECIST)and followed up for survival,and the efficacy of the treatments in two groups was compared.The postoperative adverse events were recorded and compared between the two treatment groups.The degree of pain was evaluated by visual analogue scale(VAS).The degree of vomiting and fever was evaluated according to CTCAE version 4.0 and the liver function of patients before and 3 days after operation was compared.Results The overall objective response rate(ORR)of patients in the DEB-TACE group was significantly higher than that in the cTACE group(58.8%vs.16.7%,P=0.012).The median survival period of patients in the DEB-TACE group was 14(9,24)months,which was longer that in the cTACE group 12(8,24)months(P=0.697).There were no severe adverse events in the two groups after operation,but the incidence of post-embolization syndrome in the DEB-TACE group was significantly higher than that in the cTACE group(94.1%vs.55.6%,P=0.026),and abdominal pain was the most common symptom(94.1%vs.44.4%,P=0.002).However,different degrees of liver function injury occurred in both groups after surgery,and the difference was not statistically significant(P>0.05).Conclusion DEB-TACE is safe and effective in the treatment of unresectable ICC without distant metastasis,and its short-term efficacy for unresectable ICC is better than that of cTACE.

关 键 词：载药微球 肝内胆管细胞癌 安全性 有效性 

分 类 号：R735.7[医药卫生—肿瘤]