Nabil Mohamed, Gruber Tatjana, Yakoub Danny, Ackermann Hanns, Zangos Stephan, Vogl Thomas J
Institute of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
Eur Radiol. 2008 Jul;18(7):1456-63. doi: 10.1007/s00330-008-0887-z. Epub 2008 Feb 29.
The purpose was to evaluate the effectiveness of transarterial chemoembolization (TACE) in local tumor control and survival in patients with hepatic metastases from renal cell carcinoma (RCC). Prospective evaluation of TACE treatment outcome in 22 patients recruited from 1999 and 2005 was performed. The chemotherapeutic agent used was mitomycin only in 45% of the patients and mitomycin together with gemcitabine in the other 55%. The embolizing materials used in all of the patients were iodized oil (lipiodol) and degradable starch microspheres. Local response was evaluated by MRI and judged according to Response Evaluation Criteria in Solid Tumors (RECIST). Mean and median survival and survival probability after diagnosis and treatment were both calculated by Kaplan-Meier method. Partial response was achieved in 13.7%, stable disease in 59% and progressive disease in 27.3% of patients. Survival time from the diagnosis of metastases ranged from 18 to 307 months and from 2.2 to 35 months from the start of TACE treatment. The median and mean survival times from the date of diagnosis were 68.6 and 102.9 months, respectively. The median and mean survival times from the start of TACE were 8.2 and 11.7 months, respectively. Survival probability from the start of treatment was 31% after 1 year and 6% after 2 years. TACE can result in a favorable local tumor response in patients with hepatic metastases from RCC, but survival results are still limited.
目的是评估经动脉化疗栓塞术(TACE)对肾细胞癌(RCC)肝转移患者局部肿瘤控制及生存情况的有效性。对1999年至2005年招募的22例患者的TACE治疗结果进行了前瞻性评估。仅45%的患者使用丝裂霉素作为化疗药物,其余55%的患者使用丝裂霉素联合吉西他滨。所有患者使用的栓塞材料为碘化油(碘油)和可降解淀粉微球。通过MRI评估局部反应,并根据实体瘤疗效评价标准(RECIST)进行判断。采用Kaplan-Meier法计算诊断和治疗后的平均及中位生存期以及生存概率。13.7%的患者达到部分缓解,59%的患者病情稳定,27.3%的患者病情进展。从转移诊断开始的生存时间为18至307个月,从TACE治疗开始为2.2至35个月。诊断日期后的中位和平均生存时间分别为68.6个月和102.9个月。TACE开始后的中位和平均生存时间分别为8.2个月和11.7个月。治疗开始后的1年和2年生存概率分别为31%和6%。TACE可使RCC肝转移患者获得良好的局部肿瘤反应,但生存结果仍然有限。