Department of Hepatology, Toranomon Hospital, Tokyo, Japan. norihiro.imai @ gmail.com
Oncology. 2011;80(3-4):188-94. doi: 10.1159/000328749. Epub 2011 Jun 27.
The purpose of this retrospective study was to evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) with miriplatin in patients with unresectable hepatocellular carcinoma (HCC).
From 2007 to 2010, 122 consecutive patients with unresectable HCC were treated by TACE with miriplatin-lipiodol suspension in our institute. Twenty-two patients (18%) had a solitary nodule and 100 patients (82%) had multiple nodules. Ninety-eight patients (80%) had a history of TACE.
Thirty-five of the 122 treated patients (29%) showed complete response (CR). And no serious complications were observed. Patients who had shown CR after previous TACE (pre-CR) were significantly more likely to show CR in the current study compared with patients who had shown less successful responses after previous TACE (56 vs. 20%, p = 0.003). Multivariate analysis revealed that response after previous TACE (pre-CR, risk ratio: 4.76; p = 0.035), tumor multiplicity (solitary, risk ratio: 9.69; p = 0.003), and injection artery (peripheral to segmental hepatic artery, risk ratio: 5.28;p = 0.040) were significant independent predictors associated with CR after TACE using miriplatin.
In repetition of TACE treatment, switching the TACE agent from epirubicin or cisplatin to miriplatin offered a favorable treatment effect, especially in patients who had shown a CR after previous TACE.
本回顾性研究旨在评估经导管肝动脉化疗栓塞（TACE）联合米立铂治疗不可切除肝细胞癌（HCC）的疗效和安全性。
2007 年至 2010 年，我院采用米立铂碘油混悬剂对 122 例不可切除 HCC 患者进行 TACE 治疗。22 例（18%）患者为单发结节，100 例（82%）患者为多发结节。98 例（80%）患者有 TACE 治疗史。
122 例患者中有 35 例（29%）显示完全缓解（CR）。未观察到严重并发症。与 TACE 治疗后反应不佳的患者相比（56%比 20%，p=0.003），TACE 治疗前已显示 CR（pre-CR）的患者在本次研究中更有可能显示 CR。多因素分析显示，TACE 治疗前的反应（pre-CR，风险比：4.76；p=0.035）、肿瘤数量（单发，风险比：9.69；p=0.003）和注射动脉（外周至节段性肝动脉，风险比：5.28；p=0.040）是与米立铂 TACE 后 CR 相关的显著独立预测因素。
在重复 TACE 治疗中，将 TACE 药物从表柔比星或顺铂转换为米立铂可获得良好的治疗效果，尤其是在 TACE 治疗前已显示 CR 的患者中。
