Kucukay Fahrettin, Badem Serife, Karan Adnan, Ozdemir Mustafa, Okten Riza S, Ozbulbul Nilgun I, Kucukay Murat B, Unlu Ipek, Bostanci Erdal B, Akdogan Meral
Department of Interventional Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
Department of Interventional Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
J Vasc Interv Radiol. 2015 Nov;26(11):1622-9. doi: 10.1016/j.jvir.2015.07.017. Epub 2015 Aug 28.
To compare doxorubicin-loaded HepaSphere transarterial chemoembolization versus conventional transarterial chemoembolization in terms of survival, time to recurrence, acute reversible hepatotoxicity, postembolization syndrome, and chemoembolization-related mortality and morbidity.
One hundred twenty-six patients (103 men, 23 women; mean age, 64.3 y) with unresectable hepatocellular carcinoma (HCC) who underwent conventional chemoembolization between January 2007 and March 2011 or drug-eluting embolic (DEE) chemoembolization (after the protocol change) between March 2011 and October 2014 were included in a retrospective analysis. Primary outcome measures were survival and time to recurrence. Secondary outcome measures were frequency of recurrence, technical success, acute reversible hepatotoxicity, postembolization syndrome, and chemoembolization-related mortality and morbidity.
The technical success rate was 97.1%. There were no significant differences between the conventional and DEE chemoembolization groups with regard to mean survival duration (39.0 vs 37.4 mo), recurrence (32.9% vs 39.6%), postembolization syndrome (90% vs 89%), and chemoembolization-related mortality (5.5% vs 1.9%) and morbidity (9.6% vs 9.4%; P > .05). The time to recurrence was shorter in DEE chemoembolization-treated patients than in conventional chemoembolization-treated patients (5.0 vs 11.5 mo; P = .006), and acute reversible hepatotoxicity occurred more frequently after conventional chemoembolization (P = .019).
Conventional chemoembolization and DEE chemoembolization were safe and effective interventions for unresectable HCC. DEE chemoembolization was not better than conventional chemoembolization in terms of survival and was associated with a shorter time to recurrence. Acute reversible hepatotoxicity occurred more frequently after conventional chemoembolization.
比较载有多柔比星的肝动脉化疗栓塞术（HepaSphere）与传统肝动脉化疗栓塞术在生存率、复发时间、急性可逆性肝毒性、栓塞后综合征以及化疗栓塞相关的死亡率和发病率方面的差异。
对2007年1月至2011年3月期间接受传统化疗栓塞术，或2011年3月至2014年10月期间接受药物洗脱栓塞（DEE）化疗栓塞术（方案改变后）的126例无法切除的肝细胞癌（HCC）患者（103例男性，23例女性；平均年龄64.3岁）进行回顾性分析。主要观察指标为生存率和复发时间。次要观察指标为复发频率、技术成功率、急性可逆性肝毒性、栓塞后综合征以及化疗栓塞相关的死亡率和发病率。
技术成功率为97.1%。在平均生存时间（39.0个月对37.4个月）、复发率（32.9%对39.6%）、栓塞后综合征（90%对89%）以及化疗栓塞相关死亡率（5.5%对1.9%）和发病率（9.6%对9.4%；P>.05）方面，传统化疗栓塞组与DEE化疗栓塞组之间无显著差异。DEE化疗栓塞治疗的患者复发时间比传统化疗栓塞治疗的患者短（5.0个月对11.5个月；P=.006），且传统化疗栓塞后急性可逆性肝毒性的发生频率更高（P=.019）。
传统化疗栓塞术和DEE化疗栓塞术是治疗无法切除HCC的安全有效干预措施。在生存率方面，DEE化疗栓塞术并不优于传统化疗栓塞术，且其复发时间较短。传统化疗栓塞后急性可逆性肝毒性的发生频率更高。
