Department of Medicine, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong, China.
Cancer. 2009 Dec 1;115(23):5507-15. doi: 10.1002/cncr.24636.
The authors evaluated and compared the treatment outcomes of transarterial chemoembolization (TACE) between young (<or=70 years) and elderly (>70 years) patients at their institute over an 18-year period.
Advanced hepatocellular carcinoma (HCC) patients who received TACE at the authors' center were analyzed retrospectively. The demographic data, TACE-related morbidities, and survival outcome were compared between these 2 age groups.
Between 1989 and 2006, 843 patients who were <or=70 years old and 197 patients who were >70 years old received TACE treatment for advanced HCC. There were significantly more comorbid illnesses associated with the elderly patients than the young patients (64 % vs 33%, P < .01). Moreover, elderly patients who received TACE treatment for HCC were at earlier stages of disease (P < .01). Both the overall median survival (14.0 months vs 8.1 months, P < .003) and disease-specific survival (15.2 months vs 8.7 months, P < .001) were significantly higher in elderly than young patients. The most commonly encountered TACE-related morbidity in both age groups was liver function derangement. Young patients had a significantly higher rate of developing liver derangement after TACE than elderly patients (21% vs 11%, P < .01). Conversely, the elderly patients had a significantly higher rate of developing peptic ulcer disease with TACE treatment than young patients (2.5% vs 0.5%, P = .01). Overall, there was no significant difference in TACE-related mortality between the young and elderly patients (3% vs 4%, P = .49).
This study has confirmed the comparable efficacy and tolerability in using TACE for the treatment of advanced HCC in young and elderly patient populations.
作者评估比较了他们所在机构在 18 年期间对年轻（≤70 岁）和老年（>70 岁）患者进行的经动脉化疗栓塞（TACE）治疗效果。
回顾性分析作者所在中心接受 TACE 治疗的晚期肝细胞癌（HCC）患者。比较了这两组患者的人口统计学数据、TACE 相关并发症和生存结局。
1989 年至 2006 年，843 名年龄≤70 岁和 197 名年龄>70 岁的患者接受 TACE 治疗晚期 HCC。与年轻患者相比，老年患者患有更多的合并症（64%比 33%，P<.01）。此外，接受 TACE 治疗的老年 HCC 患者处于疾病早期（P<.01）。老年患者的总中位生存期（14.0 个月比 8.1 个月，P<.003）和疾病特异性生存期（15.2 个月比 8.7 个月，P<.001）均显著长于年轻患者。两组患者 TACE 相关最常见的并发症是肝功能异常。与年轻患者相比，老年患者 TACE 后肝功能异常的发生率明显更高（21%比 11%，P<.01）。相反，老年患者 TACE 治疗后发生消化性溃疡病的比例明显高于年轻患者（2.5%比 0.5%，P=.01）。总体而言，年轻和老年患者 TACE 相关死亡率无显著差异（3%比 4%，P=.49）。
本研究证实，TACE 治疗年轻和老年 HCC 患者的疗效和耐受性相当。
