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肝癌载药微球栓塞后局部肿瘤进展:米立培南与表柔比星的回顾性比较。

Local tumor progression following lipiodol-based targeted chemoembolization of hepatocellular carcinoma: a retrospective comparison of miriplatin and epirubicin.

机构信息

Department of Radiology, Nissay Hospital, Nishiku, Osaka.

出版信息

Cancer Manag Res. 2012;4:113-9. doi: 10.2147/CMAR.S30431. Epub 2012 Apr 19.

Abstract

PURPOSE

We aimed to compare the local control rates between miriplatin and epirubicin in lipiodol-based transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).

PATIENTS AND METHODS

Patients who underwent targeted TACE using miriplatin (47 patients, 66 lesions) or epirubicin (64 patients, 79 lesions) as the sole therapy were enrolled. The local control rates were compared using the Kaplan-Meier estimator with the log-rank test. The patient and tumor parameters were subjected to univariate and multivariate analyses using the Cox proportional hazards model.

RESULTS

The overall local recurrence rates were 39.3% and 31.6% for the miriplatin and epirubicin groups, respectively. The local control rate was significantly higher in the epirubicin group than in the miriplatin group (P < 0.001). The local control rates at 6 months and 1 year were 70.7% and 44.8% for the miriplatin group and 83.4% and 69.2% for the epirubicin group, respectively. Multivariate analysis showed that the serum α-fetoprotein level ≥ 20 ng/mL (hazard ratio 2.96; P < 0.001), miriplatin usage (hazard ratio 2.53; P = 0.002), and Child-Pugh class B (hazard ratio 1.89; P = 0.042) affected local progression.

CONCLUSION

Lipiodol-based targeted TACE using miriplatin had inferior local control rates as compared to epirubicin in patients with HCC.

摘要

目的

本研究旨在比较载碘油的经动脉化疗栓塞术(TACE)中使用米立铂与表柔比星时肝癌(HCC)的局部控制率。

方法

本研究纳入了接受米立铂(47 例患者,66 个病灶)或表柔比星(64 例患者,79 个病灶)作为唯一治疗药物的 TACE 靶向治疗患者。采用 Kaplan-Meier 估计值和对数秩检验比较局部控制率。采用 Cox 比例风险模型对患者和肿瘤参数进行单因素和多因素分析。

结果

米立铂组和表柔比星组的总体局部复发率分别为 39.3%和 31.6%。表柔比星组的局部控制率显著高于米立铂组(P < 0.001)。米立铂组和表柔比星组的 6 个月和 1 年局部控制率分别为 70.7%和 44.8%、83.4%和 69.2%。多因素分析显示,血清甲胎蛋白水平≥20ng/mL(风险比 2.96;P < 0.001)、使用米立铂(风险比 2.53;P = 0.002)和 Child-Pugh 分级 B(风险比 1.89;P = 0.042)影响局部进展。

结论

与表柔比星相比,米立铂载碘油 TACE 治疗 HCC 患者的局部控制率较低。

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