[1]周腾超,龙 林,孙 林,等.载药微球对比传统化疗栓塞治疗分支门脉癌栓肝癌的临床研究[J].介入放射学杂志,2024,33(06):616-622.
 ZHOU Tengchao,LONG Lin,SUN Lin,et al.Drug-eluting beads versus conventional chemoembolization for liver cancer with branch portal vein tumor thrombus: a clinical study[J].journal interventional radiology,2024,33(06):616-622.
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载药微球对比传统化疗栓塞治疗分支门脉癌栓肝癌的临床研究()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年06
页码:
616-622
栏目:
肿瘤介入
出版日期:
2024-06-20

文章信息/Info

Title:
Drug-eluting beads versus conventional chemoembolization for liver cancer with branch portal vein tumor thrombus: a clinical study
作者:
周腾超 龙 林 孙 林 龙 瑶
Author(s):
ZHOU Tengchao LONG Lin SUN Lin LONG Yao.
Department of Interventional Vascular Surgery, First Affiliated Hospital of Hunan Normal University (Hunan Provincial People’s Hospital), Changsha, Hunan Province 410002, China
关键词:
【关键词】 经导管动脉内化疗栓塞 载药微球 碘油 分支门脉癌栓 疗效
文献标志码:
A
摘要:
【摘要】 目的 对比不同经导管动脉内化疗栓塞(TACE)方式应用于分支门脉癌栓(PVTT)肝细胞癌(HCC)患者的疗效及安全性。方法 回顾性纳入自2019年12月至2022年8月符合纳排标准的122例有分支PVTT的HCC患者,根据不同的TACE方式分为载药微球组(DEB-TACE)和传统TACE组(cTACE)。通过比较两组患者术后并发症、疼痛来评估两者的安全性。比较两组患者术后1个月的肿瘤反应率、术后的无进展生存时间(PFS)和总体生存时间(OS),探究哪一种TACE方式对有分支PVTT的HCC患者疗效更优。结果 两组的术后疼痛分级和并发症发生率基本无差异。TACE后1个月,DEB-TACE组的ORR(P=0.033)及DCR(P=0.096)优于cTACE组。DEB-TACE组和cTACE组的中位PFS分别为10.5个月及6.4个月(P=0.003),中位OS为19.3个月及16.8个月(P=0.019)。结论 TACE应用于分支PVTT的HCC患者是有效、安全的,DEB-TACE的术后疗效优于cTACE。为提高这部分患者的预后,我们更应该推荐DEB-TACE作为初次介入治疗的方式。

参考文献/References:

 

[1] 中国抗癌协会肝癌专业委员会.中国肿瘤整合诊治指南- 肝癌(2022精简版)[J].中国肿瘤临床, 2022, 49:993.

[2] Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation: the 2022 update[J]. J Hepatol, 2022, 76: 681- 693.

[3] 安天志,高 嵩,靳 勇,等. 中国肝细胞癌经动脉化疗栓塞治疗临床实践指南[J]. 中华介入放射学电子杂志, 2019, 7:178- 184.

[4] Silva JP,Berger NG,Tsai S,et al. Transarterial chemoembolization in hepatocellular carcinoma with portal vein tumor thrombosis: a systematic review and meta- analysis[J]. HPB (Oxford), 2017, 19: 659- 666.

[5] Razi M, Safiullah S, Gu J, et al. Comparison of tumor response following conventional versus drug- eluting bead transarterial chemoembolization in early- and very early- stage hepatocellular carcinoma[J]. J Interv Med, 2021, 5: 10- 14.

[6] Kloeckner R,Weinmann A,Prinz F,et al. Conventional transar- terial chemoembolization versus drug- eluting bead transarterial chemoembolization for the treatment of hepatocellular carcinoma[J]. BMC Cancer, 2015, 15: 465.

[7] Shi J,Lai EC,Li N,et al. A new classification for hepatocellular carcinoma with portal vein tumor thrombus[J]. J Hepatobiliary Pancreat Sci, 2011, 18: 74- 80.

[8] Khalilzadeh O,Baerlocher MO,Shyn PB,et al. Proposal of a new adverse event classification by the society of interventional radiology standards of practice committee[J]. J Vasc Interv Radiol, 2017, 28: 1432- 1437.

[9] Hawker G, Mian S, Kendzerska T, et al. Measures of adult pain: Visual Analog Scale for Pain(VAS Pain), Numeric Rating Scale for Pain(NRS Pain), McGill Pain Questionnaire(MPQ), Short- Form McGill Pain Questionnaire(SF- MPQ), Chronic Pain Grade Scale (CPGS), Short Form- 36 Bodily Pain Scale (SF- 36 BPS),and Measure of Intermittent and Constant Osteoarthritis Pain(ICOAP)[J]. Arthritis Care Res(Hoboken), 2011, 63: S240- S252.

[10] 刘 崎,贾雨辰,贺 佳,等. 肝癌合并门脉癌栓的化疗栓塞治疗[J]. 中华放射学杂志, 1995, 29:239- 242.

[11] Chern MC, Chuang VP, Liang CT, et al. Transcatheter arterial chemoembolization for advanced hepatocellular carcinoma with portal vein invasion: safety, efficacy, and prognostic factors[J]. J Vasc Interv Radiol, 2014, 25: 32- 40.

[12] 喻安琪,杨继元. 肝动脉栓塞化疗治疗肝癌合并门静脉癌栓的研究进展[J]. 癌症进展, 2020, 18:977- 980.

[13] 陈科利,高 建. 原发性肝癌合并门静脉癌栓的TACE治疗进展[J]. 科学咨询, 2020:20- 21.

[14] Chung GE,Lee JH,Kim HY,et al. Transarterial chemoembo-lization can be safely performed in patients with hepatocellular carcinoma invading the main portal vein and may improve the overall survival[J]. Radiology, 2011, 258: 627- 634.

[15] Xue J,Ni H,Wang F,et al. Advances in locoregional therapy for hepatocellular carcinoma combined with immunotherapy and targeted therapy[J]. J Interv Med, 2021, 4: 105- 113.

[16] 韩建军,宋金龙,谢印法,等. 载药微球治疗恶性肝脏肿瘤的全程管理[J]. 中华介入放射学电子杂志, 2019, 7:7- 16.

[17] 王 志,陆骊工,陈 磊,等. 无痛介入——我们仍需做得更多[J]. 介入放射学杂志, 2022, 31:949- 953.

[18] Chu HH,Gwon DI,Kim JH,et al. Drug- eluting microsphere versus cisplatin- based transarterial chemoembolization for the treatment of hepatocellular carcinoma: propensity score- matched analysis[J]. AJR Am J Roentgenol, 2020, 215: 745- 752.

[19] Han T, Yang X, Zhang Y, et al. The clinical safety and efficacy of conventional transcatheter arterial chemoembolization and drug- eluting beads- transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma: a meta- analysis[J]. Biosci Trends, 2019, 13: 374- 381.

[20] 江福生,王 敏,郑 伟,等. 载药微球与碘油动脉化疗栓塞治疗巨块型肝癌效果对比研究[J]. 江西医药, 2021, 56:930- 933, 964.

[21] Tang J, Huang Z, Xu J, et al. Drug- eluting bead transarterial chemoembolization(TACE) exhibits superior efficacy and equal tolerance to conventional TACE in hepatocellular carcinoma patients with conventional TACE history[J]. Clin Res Hepatol Gastroenterol, 2022, 46: 101814.

[22] Shi Q,Liu J,Li T,et al. Comparison of DEB- TACE and cTACE for the initial treatment of unresectable hepatocellular carcinoma beyond up- to- seven criteria: a single- center propensity score matching analysis[J]. Clin Res Hepatol Gastroenterol, 2022, 46: 101893.

[23] Kim JH,Shim JH,Yoon HK,et al. Chemoembolization related to good survival for selected patients with hepatocellular carcinoma invading segmental portal vein[J]. Liver Int, 2018, 38: 1646- 1654.

[24] Daly LE, Dolan RD, Power DG, et al. Determinants of quality of life in patients with incurable cancer[J]. Cancer, 2020, 126:2872- 2882.

[25] Kim BK, Kim SU, Kim KA, et al. Complete response at first chemoembolization is still the most robust predictor for favorable outcome in hepatocellular carcinoma[J]. J Hepatol, 2015, 62: 1304- 1310.

[26] Kudo M, Kawamura Y, Hasegawa K, et al. Management of hepatocellular carcinoma in Japan: JSH consensus statements and recommendations 2021 update[J]. Liver Cancer, 2021, 10: 181- 223.

 

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备注/Memo

备注/Memo:

(收稿日期:2023- 06- 16)

(本文编辑:茹 实)

更新日期/Last Update: 2024-06-20