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比较表柔比星联合丝裂霉素 C 与米瑞铂行超选择性经导管肝动脉化疗栓塞术对肝癌的局部控制效果。

Comparison of local control effects of superselective transcatheter arterial chemoembolization using epirubicin plus mitomycin C and miriplatin for hepatocellular carcinoma.

机构信息

Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui 918-8503, Japan.

出版信息

Jpn J Radiol. 2012 Apr;30(3):263-70. doi: 10.1007/s11604-011-0043-6. Epub 2012 Jan 7.

Abstract

PURPOSE

To compare local control effects of superselective transcatheter arterial chemoembolization (TACE) using epirubicin (EPI) plus mitomycin C (M) and miriplatin (MPT) for hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

One-hundred and twenty-nine HCCs treated with superselective TACE were divided into three groups according to the type of anticancer drug; EPI-M-TACE (n = 51), MPT-TACE (n = 21), and MPT-I-TACE (MPT emulsion) (n = 57). Local recurrence, patterns of recurrence (intratumoral recurrence; IR), and follow-up angiograms were evaluated.

RESULTS

Mean tumor diameter and follow-up period for the EPI-M-TACE, MPT-TACE, and MPT-I-TACE groups were 16.9 mm and 15.5 months, 20.7 mm and 12.0 months, and 18.8 mm and 9.6 months, respectively. Local recurrence for the EPI-M-TACE, MPT-TACE, and MPT-I-TACE groups at 5, 10, and 15 months was 6.1, 47.6, and 40.1%, 23.5, 67.3, and 63.9%, and 26.2, 75.4, and 72.9%, respectively. IR for the EPI-M-TACE, MPT-TACE, and MPT-I-TACE groups was 23.1, 71.4, and 71.0%, respectively. Local recurrence and IR in the EPI-M-TACE group were significantly less than those in the MPT-TACE and MPT-I-TACE groups. Follow-up angiograms revealed less arterial damage in the MPT-TACE and MPT-I-TACE groups.

CONCLUSION

Superselective TACE using MPT resulted in very frequent local recurrence, in particular IR, despite less arterial damage.

摘要

目的

比较表阿霉素(EPI)联合丝裂霉素 C(M)与米立铂(MPT)行超选择性经导管肝动脉化疗栓塞(TACE)治疗肝细胞癌(HCC)的局部控制效果。

材料与方法

根据抗癌药物的类型,将 129 例 HCC 患者分为三组行超选择性 TACE 治疗,EPI-M-TACE 组(n = 51)、MPT-TACE 组(n = 21)和 MPT-I-TACE 组(MPT 乳剂)(n = 57)。评估局部复发、复发模式(肿瘤内复发;IR)和随访血管造影。

结果

EPI-M-TACE、MPT-TACE 和 MPT-I-TACE 组的平均肿瘤直径和随访时间分别为 16.9 mm 和 15.5 个月、20.7 mm 和 12.0 个月、18.8 mm 和 9.6 个月。EPI-M-TACE、MPT-TACE 和 MPT-I-TACE 组在 5、10 和 15 个月时的局部复发率分别为 6.1%、47.6%和 40.1%、23.5%、67.3%和 63.9%、26.2%、75.4%和 72.9%。EPI-M-TACE、MPT-TACE 和 MPT-I-TACE 组的 IR 分别为 23.1%、71.4%和 71.0%。EPI-M-TACE 组的局部复发和 IR 明显低于 MPT-TACE 和 MPT-I-TACE 组。MPT-TACE 和 MPT-I-TACE 组的随访血管造影显示动脉损伤较少。

结论

尽管动脉损伤较小,但 MPT 行超选择性 TACE 治疗后局部复发,特别是 IR 非常频繁。

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