摘要
目的评价载药微球经导管动脉化疗栓塞(drug-eluting beads-trancatheter arterial chemoembolization,DEB-TACE)治疗对传统导管动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)抵抗的原发性肝癌的安全性及有效性。方法回顾分析2017年1月至2021年1月解放军联勤保障部队第九八〇医院对传统TACE抵抗的原发性肝癌行DEB-TACE治疗25例患者的临床资料,采用改良实体瘤疗效评价标准(m RECIST)统计分析临床疗效,比较治疗前后肝功能变化,记录并发症发生情况。结果25例患者共实施DEB-TACE治疗36例次,栓塞终点为肿瘤染色消失,供血动脉闭塞。根据mRECIST标准,DEB-TACE术后1个月、3个月和6个月患者的客观缓解率(ORR)分别为92%、72%和60%,疾病控制率(DCR)分别为96%、88%和80%。DEB-TACE术后第3天,AST和ALT升高,差异有统计学意义(P<0.05),术后7 d逐步好转,术后30 d恢复至术前水平,与术前比较差异无统计学意义(P>0.05)。总胆红素及白蛋白变化不大,治疗前后差异无统计学意义(P>0.05)。未出现肝衰竭、肝脓肿及骨髓抑制等严重并发症。结论DEB-TACE治疗对传统TACE抵抗的中期原发性肝癌安全、有效。
Objective To evaluate the clinical safety and effect of drug-eluting beads-trancatheter arterial chemoembolization(DEB-TACE)in treating hepatocellular carcinoma(HCC)refractory to conventional transcatheter arterial chemoembolization(C-TACE).MethodsThe clinical date of 25 patients with HCC refractory to C-TACE,who received DEB-TACE at No.980 Hospital of PLA Joint Logistics Support Forces of China between January 2017 and January 2021,were retrospectively analyzed.By using modified Response Evaluation Criteria in Solid Tumors(mRECIST),the clinical effect was analyzed,the incidence of adverse reactions were recorded,and the postoperative changes of liver functions were compared with preoperative ones.ResultsA total of 36 DEB-TACE procedures were performed in the 25 patients.The end point of embolization procedure was the disappearance of tumor staining and the occlusion of the tumor-feeding arteries.According to mRECIST,the postoperative 1-month,3-month and 6-month objective response rates(ORR)were 92%,72%and 60%respectively,and the disease control rates(DCR)were96%,88%and 80%respectively.On the third day after DEB-TACE treatment,the levels of aspartate aminotransferase(AST)and alanine aminotransferase(ALT)showed a statistically significant elevation when compared with preoperative ones(P<0.05),which started to be gradually improved 7 days after DEB-TACE and returned to the baseline levels one month after DEB-TACE,which became not statistically significant different from the preoperative ones(P>0.05).The postoperative levels of total bilirubin(TBIL)and albumin(ALB)showed no obvious changes when compared with preoperative ones(P>0.05).No severe complications such as hepatic failure,liver abscess,or bone marrow suppression occurred.ConclusionFor the treatment of mid-stage HCC that is refractory to C-TACE,DEB-TACE is clinically safe and effective.
作者
曹莉明
张勇学
梁志会
李亮
崔进国
CAO Liming;ZHANG Yongxue;LIANG Zhihui;LI Liang;CUI Jinguo(Department of Interventional Therapy,No.980 Hospital of PLA Joint Logistics Support Forces(Bethune International Peace Hospital),Shijiazhuang,Hebei Province 050082,China)
出处
《介入放射学杂志》
CSCD
北大核心
2023年第1期59-62,共4页
Journal of Interventional Radiology
基金
河北省医学科学研究重点课题(20211761)
关键词
原发性肝癌
TACE抵抗
肝硬化
肝动脉化疗栓塞术
载药微球
hepatocellular carcinoma
TACE-resistance
cirrhosis
transcatheter arterial chemoembolization
drug-eluting beads
