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经动脉化疗栓塞术(TACE)联合S-1治疗对TACE难治的BCLC B期肝细胞癌

Transcatheter arterial chemoembolisation (TACE) plus S-1 for the treatment of BCLC stage B hepatocellular carcinoma refractory to TACE.

作者信息

Huang Wu-Kui, Yang Shu-Fa, You Li-Na, Liu Mo, Liu Deng-Yao, Gu Peng, Fan Xi-Wen

机构信息

Department of Intervention Radiology, the Affiliated Tumour Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; These authors contributed equally to this work.

Department of Traditional Chinese Medicine, the Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; These authors contributed equally to this work.

出版信息

Contemp Oncol (Pozn). 2016;20(6):468-474. doi: 10.5114/wo.2016.65607. Epub 2017 Jan 12.

Abstract

AIM OF THE STUDY

To assess the efficacy and safety of transcatheter arterial chemoembolization (TACE) plus S-1 for the treatment of Barcelona Clinic Liver Cancer (BCLC) Stage B HCC refractory to TACE.

MATERIAL AND METHODS

26 patients meeting the eligibility criteria were enrolled. TACE was given on day 1, and S-1 on days 2-15. Tumor assessment was performed one month later according to mRECIST. The primary endpoints were TTP and OS.

RESULTS

Twenty-six patients received 176 TACE interventions in all. Fifteen patients of TACE plus S-1 received a total of 55 cycles of treatment of S-1, with a median of 4 cycles (range, 2-6). The total dose of S-1 was 6165 mg per day, while average was 120 mg (range, 100-125 mg) for 15 patients of TACE plus S-1. Median TTP and OS of TACE plus S-1 were 6 months (95% CI: 4.7-7.3) and 18 months (95% CI: 15.3-24.7), respectively, while TACE monotherapy was 4 months (95% CI: 2.4-5.6) and 13 months (95% CI: 9.8-16.2), respectively, and significant differences were detected. Though there were higher DCRs in patients of TACE plus S-1, no significant differences were detected. A total of 612 adverse events occurred during the course of the treatment, 367 in TACE plus S-1 and 245 in TACE mono-therapy. There were significant differences to anorexia and nausea, but they were tolerable.

CONCLUSIONS

TACE plus S-1 in the present analysis was tolerable and associated with an interesting TTP and OS. TACE plus S-1 may be used as a new treatment method to BCLC Stage B HCC refractory to TACE.

摘要

研究目的

评估经动脉化疗栓塞术(TACE)联合S-1治疗对TACE难治的巴塞罗那临床肝癌(BCLC)B期肝细胞癌(HCC)的疗效和安全性。

材料与方法

纳入26例符合入选标准的患者。第1天进行TACE,第2 - 15天给予S-1。1个月后根据改良RECIST标准进行肿瘤评估。主要终点为疾病进展时间(TTP)和总生存期(OS)。

结果

26例患者共接受176次TACE干预。15例接受TACE联合S-1治疗的患者共接受55个周期的S-1治疗,中位数为4个周期(范围2 - 6个周期)。TACE联合S-1治疗的15例患者S-1的总剂量为每日6165 mg,平均剂量为120 mg(范围100 - 125 mg)。TACE联合S-1治疗的中位TTP和OS分别为6个月(95%置信区间:4.7 - 7.3)和18个月(95%置信区间:15.3 - 24.7),而单纯TACE治疗分别为4个月(95%置信区间:2.4 - 5.6)和13个月(95%置信区间:9.8 - 16.2),差异有统计学意义。虽然TACE联合S-1治疗的患者疾病控制率(DCR)较高,但差异无统计学意义。治疗过程中总共发生612例不良事件,TACE联合S-1治疗组367例,单纯TACE治疗组245例。在厌食和恶心方面差异有统计学意义,但均可耐受。

结论

本分析中TACE联合S-1治疗耐受性良好,且TTP和OS结果令人满意。TACE联合S-1可作为对TACE难治的BCLC B期HCC的一种新的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3734/5320460/4302e621726f/WO-20-29321-g001.jpg

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