改良DEB-TACE治疗不可手术切除富血供大肝癌的疗效与安全性  

The efficacy and safety of modified DEB-TACE in the treatment of unresectable large hypervascular hepatocellular carcinoma

作　　者：刘松 李龙 王庆东 于广计 LIU Song;LI Long;WANG Qingdong;YU Guangji(Department of Intervention,Linyi Cancer Hospital,Linyi,Shandong 276034,China)

机构地区：[1]临沂市肿瘤医院介入科,山东临沂276034

出　　处：《中国临床研究》2024年第11期1746-1750,1757,共6页Chinese Journal of Clinical Research

基　　金：山东省医药卫生科技发展计划项目(202309040623)。

摘　　要：目的回顾分析改良的载药微球的经动脉化疗栓塞术(DEB-TACE)治疗不可手术切除富血供大肝癌的临床疗效与安全性。方法回顾性分析2019年1月至2022年9月临沂市肿瘤医院收治的169例不可手术切除富血供大肝癌的临床资料,所有患者均接受改良的DEB-TACE治疗。应用修订后实体瘤疗效评价标准评价患者介入术后1、3、6个月的肿瘤反应;记录患者的疾病进展时间、总生存期;记录不同时间点肝功能指标及治疗过程中不良反应。结果169例患者共行改良DEB-TACE治疗403次,平均(2.38±0.74)次;首次介入术后1个月、3个月、6个月,患者的客观缓解率(ORR)分别为100%、85.1%、75.5%,疾病控制率(DCR)分别为100%、97.5%、88.8%。截至2023年9月30日,随访(27.46±9.22)个月,接受治疗患者中位生存时间为25.0个月,中位疾病进展时间为10.0个月。与改良DEB-TACE相关的不良反应主要为发热、疼痛、恶心呕吐等,且均较轻,经对症治疗后缓解,未出现异位栓塞等严重并发症发生。DEB-TACE术后1周患者的丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)较术前有不同程度升高,术后1个月内均恢复到正常。结论应用改良DEB-TACE治疗不可手术切除富血供大肝癌疗效显著且安全。Objective To retrospectively analyze the clinical efficacy and safety of the modified drug-eluting beads transcatheter arterial chemoembolization(DEB-TACE)in the treatment of unresectable large hypervascular hepatocellular carcinoma.Methods A retrospective analysis was conducted on the clinical data of 169 cases of unresectable large hypervascular hepatocellular carcinoma admitted to Linyi Cancer Hospital from January 2019 to September 2022.All patients received modified DEB-TACE treatment.The tumor response of patients at 1,3,and 6 months after intervention was analyzed using the mRECIST standard.The disease progression time and overall survival of patients were recorded.Results A total of 169 patients underwent 403 rounds of modified DEB-TACE treatment,with an average of(2.38±0.74).At 1,3,and 6 months after the first intervention,the objective remission rate(ORR)of the patients was 100%,85.1%,and 75.5%,and the disease control rate(DCR)was 100%,97.5%,and 88.8%,respectively.As of September 30,2023,with a mean follow-up of(27.46±9.22)months,the median overall time for treated patients was 25.0 months and the median time to progression was 10.0 months.Adverse reactions associated with modified DEB-TACE were mainly fever,pain,nausea and vomiting,which were mild and relieved by symptomatic treatment,and no serious complications such as ectopic embolism occurred.ALT and AST of the patients at 1 week after DEB-TACE were differently elevated compared with the preoperative period,and all of them were returned to normal within 1 month after the operation.Conclusion The application of modified DEB-TACE in the treatment of unresectable large hypervascular hepatocellular carcinoma is significantly effective and safe.

关 键 词：肝细胞肝癌 经导管肝动脉化疗栓塞术 载药微球 明胶海绵颗粒 不良反应 

分 类 号：R735.7[医药卫生—肿瘤]