载药微球TACE联合系统治疗用于不同位置肝细胞癌效果  

Effect of drug-eluting bead DACE combined with systemic treatment for hepatocellular carcinoma in different locations

作　　者：闫杏丽 李臻[1] 李杰[1] 胡炉洪 李一帆 赵亚楠[1] 张玉元 刘俊英[2] 詹鹏超 李鑫[1] 吕培杰[3] 张延藏 YAN Xingli;LI Zhen;LI Jie;HU Luqi;LI Yifan;ZHAO Yanan;ZHANG Yuyuan;LIU Junying;ZHAN Pengchao;LI Xin;LYU Pejie;ZHANG Yancang(Department of Interventional Radiology,Henan Provincial Minimally Invasive Interventional Tumor Engineering and Technology Research Center,Key Laboratory of Innovative and Translational Interventional Oncology Technology in Zhengzhou,Zhengzhou University,Zhengzhou 450052,China;Department of Hepatology,Zhoukou Central Hospital,Zhoukou 466000,China;Department of Radiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院放射介入科、河南省肿瘤微创介入工程技术研究中心、郑州市肿瘤介入诊疗技术创新与转化重点实验室,河南郑州450052 [2]周口市中心医院肝病科,河南周口466000 [3]郑州大学第一附属医院放射科,河南郑州450052

出　　处：《中国介入影像与治疗学》2025年第4期238-242,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：中原科技创新领军人才项目(244200510020);河南省重点研发专项(241111311000)。

摘　　要：目的观察载药微球TACE(DEB-TACE)联合系统治疗用于不同位置肝细胞癌(HCC)效果。方法回顾性收集204例经DEB-TACE及系统治疗(靶向及免疫治疗)的HCC患者,根据病灶解剖学位置将86例位于门静脉主干或其第1属支1cm以内者归为中央型组,以位于其他处的118例归为周围型组。DEB-TACE后规律随访至2024年8月,对比组间DEB-TACE后1、3、6及12个月客观缓解率(ORR)及疾病控制率(DCR),以及无进展生存期(PFS)和总生存期(OS)。结果对全部患者均完成随访,中位随访时间32.6个月;期间164例死亡。组间DEB-TACE后1及3个月ORR[77.91%(67/86)vs.89.83%(106/118)、34.88%(30/86)vs.54.24%(64/118)]DEB-TACE后3及6个月DCR[51.16%(44/86)vs.66.95%(79/118)、34.88%(30/86)vs.50.00%(59/118)]差异均有统计学意义(P均<0.05)。周围型组患者PFS[30.18(9.12,48.54)个月Us.20.11(11.35,28.87)个月]及OS[37.36(17.79,56.68)个月us.23.24(3.11,43.47)个月]均长于中央型组(×3.971、4.162,P=0.048、0.041)。结论DEB-TACE联合系统治疗用于周围型HCC效果优于中央型HCC。Objective To investigate the effect of drug-eluting bead DACE(DEB-TACE)combined with systemic treatment for hepatocellular carcinoma(HCC)indifferentlocations.MethodsA total of 204HCC patientswho underwent DEB-TACE combined with systemic therapy(targeted and immunotherapy)were retrospectively collected.According to the anatomical location of HCC,86 cases with lesions located at the main trunk of portal vein(PV)or within 1 cm of the first PV branch were classified into central type group,while 118 cases with lesions located at the other areas were classified as peripheral type group.Follow-up was regularly performed after DEB-TACE until August,2024.The objective response rate(ORR)and disease control rate(DCR)at 1,3,6 and 12 months after DEB-TACE,also patients'progression-free survival(PFS)and overall survival(OS)were compared between groups.Results All patients were followed up for a median of 32.6 months,during which 164 cases died.Significant differences of ORR at 1 and 3 months afterDEB-TACE(77.91%[67/86]Jus.89.83%[106/118],34.88%[30/86]vs.54.24%[64/118])and DCRat 3 and 6 months after DEB-TACE(51.16%[44/86]us.66.95%[79/118],34.88%[30/86]vs.50.00%[59/118])were found between groups(all P<0.05).Patients'PFS(30.18[9.12,48.54]months)and OS(37.36[17.79,56.68])in peripheral type group were better than those in central type group(20.11[11.35,28.87]months and 23.24[3.11,43.47]months,x^(2)=3.971,4.162,P=0.048,0.041).Conclusion The effect of DEB-TACE combined with systemic treatment for peripheral type HCC was better than for central type HCC.

关 键 词：丁癌 肝细胞 解剖学 化学栓塞 治疗性 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]