Callispheres载药微球急诊介入治疗肝细胞癌破裂出血的疗效分析  

Short-and medium-term effects of Callispheres drug-eluting beads in the emergency intervention of ruptured hepatocellular carcinoma

作　　者：石大群 刘飞[1] 曹刚[1] 张根山[1] 徐文杰[1] 刘金[1] 刘书屹 SHI Daqun;LIU Fei;CAO Gang;ZHANG Genshan;XU Wenjie;LIU Jin;LIU Shuyi(Department of Interventional Radiology,the First People’s Hospital of Lianyungang,Lianyungang,Jiangsu 222002,China)

机构地区：[1]连云港市第一人民医院介入放射科,江苏连云港222000

出　　处：《肝胆胰外科杂志》2025年第3期185-190,共6页Journal of Hepatopancreatobiliary Surgery

基　　金：江苏省研究型医院学会转化基金专项资助项目(2024-GDZXKT-01-07);连云港市肿瘤防治科技发展计划项目(QN202302);连云港市第一人民医院青年英才项目(QN2214)。

摘　　要：目的探讨肝细胞癌破裂出血(rHCC)急诊行肝动脉化疗栓塞(TACE)术中使用Callispheres载药微球的安全性及近中期临床疗效。方法回顾性纳入2018年6月至2023年6月于连云港市第一人民医院行急诊介入治疗的60例rHCC患者,其中36例采用Callispheres载药微球作为主体栓塞材料(试验组),24例采用明胶海绵颗粒作为主体栓塞材料(对照组)。比较试验组与对照组患者介入治疗成功率、并发症发生率、治疗后疾病客观缓解率(CR+PR)及疾病控制率(CR+PR+SD),应用Kaplan-Meier法进行生存分析,对比两组患者中位无进展生存时间(mPFS)和中位总生存时间(mOS)。结果两组患者介入治疗成功率均为100%,术后并发症发生率差异不具有统计学意义(P>0.05)。试验组术后1、3、6、12个月疾病客观缓解率分别为83.3%、80.0%、65.6%、45.8%,对照组分别为75.0%、72.7%、62.5%、36.4%;试验组术后1、3、6、12个月疾病控制率分别为97.2%、85.7%、87.5%、58.3%,对照组分别为87.5%、81.8%、81.3%、54.5%。试验组患者mPFS(9个月vs 6.5个月,χ^(2)=8.126,P=0.004)和mOS(14个月vs 9个月,χ^(2)=7.688,P=0.006)均优于对照组,差异均具有统计学意义。结论rHCC行TACE术中使用Callispheres载药微球作为主体栓塞材料安全有效,近中期临床疗效满意,长期临床疗效尚需进一步进行多中心以及大样本量研究验证。Objective To investigate the safety and short-to mid-term clinical efficacy of Callispheres drug-eluting beads during transcatheter arterial chemoembolization(TACE)for the emergency treatment of ruptured hepatocellular carcinoma(rHCC).Methods A total of 60 rHCC patients who underwent emergency interventional treatment at the First People’s Hospital of Lianyungang between Jun.2018 and Jun.2023 were retrospectively included.Of these,36 patients received Callispheres drug-eluting beads as the primary embolic material(the experimental group),while 24 patients received gelatin sponge particles(the control group).The interventional treatment success rate,complication incidence rate,objective response rate(CR+PR),and disease control rate(CR+PR+SD)were compared between the two groups.Survival analysis was performed with Kaplan-Meier method to compare the median progression-free survival(mPFS)and the median overall survival(mOS)between the groups.Results The interventional treatment success rate was 100%in both groups and the postoperative complication incidence rates showed no significant statistical diff erence between the two groups(P>0.05).The objective response rates at 1,3,6,and 12 months post-treatment in the experimental group were 83.3%,80%,65.6%,and 45.8%,respectively,compared to 75.0%,72.7%,62.5%,and 36.4%for the control group.The disease control at 1,3,6,and 12 months post-treatment in the experimental group were 97.2%,85.7%,87.5%,and 58.3%,respectively,compared to 87.5%,81.8%,81.3%,and 54.5%in the control group.The experimental group had significantly longer mPFS(9 months vs 6.5 months,χ^(2)=8.126,P=0.004)and mOS(14 months vs 9 months,χ^(2)=7.688,P=0.006)than those in the control group.Conclusion For treatment of rHCC,Callispheres drug-eluting beads as the primary embolic material in TACE is safe and eff ective,with satisfactory short-to mid-term clinical effi cacy.However,further multi-center and large sample studies are needed to confirm the long-term clinical effi cacy.

关 键 词：肝细胞癌 破裂出血 肝动脉化疗栓塞 Callispheres载药微球 明胶海绵颗粒 

分 类 号：R735.7[医药卫生—肿瘤]