Duke University Medical Center, Durham, NC, USA.
Clin Colorectal Cancer. 2012 Sep;11(3):185-90. doi: 10.1016/j.clcc.2011.11.003. Epub 2012 Jan 26.
Embolizing branches of the hepatic artery lengthens survival for patients with unresectable hepatocellular carcinoma (HCC), but the benefit of combining chemotherapy with the embolizing particles remains controversial.
A retrospective review was undertaken of sequential patients with advanced HCC undergoing embolization in the past 10 years at 2 neighboring institutions and with 2 years of follow-up data. TACE was generally performed with doxorubicin plus mitomycin C.
One hundred twenty-four patients were included; 77 received TACE and 47 received TAE. On multivariable analysis stratified by institution, type of embolization and CLIP score significantly predicted PFS and time to progression (TTP), whereas CLIP score and AFP independently predicted overall survival (OS). TACE significantly prolonged PFS and TTP (P = .0004 and P = .001, respectively), but not OS (P = .83).
The addition of chemotherapy to TAE prolongs PFS and TTP. Future efforts should focus on adjunctive therapies after the embolization to increase survival.
栓塞肝动脉分支可延长不能切除的肝细胞癌（HCC）患者的生存期，但化疗联合栓塞颗粒的益处仍存在争议。
对过去 10 年在 2 家相邻机构接受栓塞治疗且有 2 年随访数据的晚期 HCC 连续患者进行回顾性分析。TACE 通常使用多柔比星加丝裂霉素 C 进行。
共纳入 124 例患者，其中 77 例接受 TACE 治疗，47 例接受 TAE 治疗。多变量分析按机构、栓塞类型和 CLIP 评分分层，PFS 和进展时间（TTP）显著预测因素，而 CLIP 评分和 AFP 独立预测总生存期（OS）。TACE 显著延长了 PFS 和 TTP（P =.0004 和 P =.001），但不延长 OS（P =.83）。
TAE 加化疗可延长 PFS 和 TTP。未来的研究重点应放在栓塞后的辅助治疗上，以提高生存率。
