Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China.
J Vasc Interv Radiol. 2010 Mar;21(3):333-8. doi: 10.1016/j.jvir.2009.11.006. Epub 2010 Feb 8.
To determine whether chemoembolization can benefit patients with unresectable recurrent hepatocellular carcinoma (HCC) after orthotopic liver transplantation (OLT).
Twenty-eight of 71 patients (39%) with unresectable recurrent HCC following OLT and without contradictions to chemoembolization were included: 14 patients received chemoembolization after OLT (chemoembolization group) and 14 matched control subjects who did not receive chemoembolization (non-chemoembolization group). Tumor response was determined with follow-up computed tomography after each chemoembolization procedure and classified into four grades according to Response Evaluation Criteria in Solid Tumors. Overall survival was evaluated from OLT and from the diagnosis of recurrent HCC.
Within a median follow-up of 14.5-months, 12 of the 14 patients in the chemoembolization group (86%) and 13 of the 14 in the non-chemoembolization group (93%) developed new recurrences. Eight of the 14 patients in the chemoembolization group (57%) showed partial tumor response (>30% reduction in the size of target lesions). Moreover, patients who underwent chemoembolization had a significantly longer overall survival after OLT (P = .0133) and after the diagnosis of HCC recurrence (P = .0338) compared to those who did not. No severe complications developed in patients receiving chemoembolization during follow-up.
Lobaplatin-based chemoembolization may elicit effective tumor response for recurrent HCCs and improve the overall survival of patients with unresectable HCC recurrence following OLT.
确定经肝移植(OLT)后无法切除的复发性肝细胞癌(HCC)患者是否可以从化疗栓塞中获益。
OLT 后无法切除的复发性 HCC 且无化疗栓塞禁忌症的 71 例患者中有 28 例(39%)被纳入:14 例患者在 OLT 后接受化疗栓塞(化疗栓塞组),14 例匹配的未接受化疗栓塞的对照患者(非化疗栓塞组)。根据实体瘤反应评价标准,通过每次化疗栓塞后的随访 CT 确定肿瘤反应,并分为四级。OLT 后和复发性 HCC 诊断后评估总生存率。
在中位数为 14.5 个月的随访中,化疗栓塞组的 14 例患者中有 12 例(86%),非化疗栓塞组的 14 例患者中有 13 例(93%)出现新的复发。化疗栓塞组的 14 例患者中有 8 例(57%)显示部分肿瘤反应(目标病变大小缩小>30%)。此外,与未接受化疗栓塞的患者相比,接受化疗栓塞的患者 OLT 后(P =.0133)和 HCC 复发后(P =.0338)的总生存率显著延长。在随访期间,接受化疗栓塞的患者未发生严重并发症。
洛铂为基础的化疗栓塞可能对复发性 HCC 产生有效的肿瘤反应,并改善 OLT 后无法切除的 HCC 复发患者的总生存率。