Department of Radiology, Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tuebingen, Germany.
Eur J Gastroenterol Hepatol. 2012 Nov;24(11):1325-32. doi: 10.1097/MEG.0b013e32835724bc.
The aim of this study was to evaluate the initial tumour response after one, respectively, two transarterial chemoembolizations (TACE) with drug-eluting (DC) beads in patients with hepatocellular carcinoma (HCC).
A total of 26 patients with clinically approved HCC underwent one or two TACE with DC Beads within 6 weeks and were evaluated after 12 weeks by MRI or computed tomography on the basis of the modified Response Evaluation Criteria in the Solid Tumours guidelines for HCC. For improved comparability of both groups, 16 patients were matched in terms of Child-Pugh classification, Barcelona classification of liver cancer, age and sex.
The overall tumour response showed progressive disease in 11% and an objective response in 89% for the double TACE group compared with progressive disease in 29.5%, objective response in 34.5% and stable disease in 35% for the single TACE group. In the matched population, absolute tumour shrinkage was 61.1 ± 28.3% for the double TACE group and 14.1 ± 38.5% for the single TACE group (P<0.05).
This retrospective study shows significantly higher tumour shrinkage in patients who underwent two TACE within 6 weeks compared with patients who underwent a single intervention in terms of the initial response rate after 12 weeks. It emphasizes the use of matched populations for the evaluation of tumour response in HCC after TACE.
本研究旨在评估肝癌患者经载药微球行一次或两次肝动脉化疗栓塞术（TACE）后的初始肿瘤应答。
共 26 例经临床证实的 HCC 患者在 6 周内行一次或两次载药微球 TACE，并在 12 周时依据改良实体瘤疗效评价标准（mRECIST）进行 MRI 或 CT 评估。为了提高两组间的可比性，16 例患者按照 Child-Pugh 分级、巴塞罗那肝癌分期、年龄和性别进行匹配。
双 TACE 组的总体肿瘤应答显示疾病进展率为 11%，客观缓解率为 89%，而单 TACE 组的疾病进展率为 29.5%，客观缓解率为 34.5%，疾病稳定率为 35%。在匹配人群中，双 TACE 组的绝对肿瘤退缩率为 61.1±28.3%，单 TACE 组为 14.1±38.5%（P<0.05）。
本回顾性研究表明，与单次介入治疗相比，在 6 周内行两次 TACE 的患者在 12 周时的初始应答率显示出更高的肿瘤退缩率。这强调了在 TACE 后评估 HCC 肿瘤应答时使用匹配人群的重要性。
