Asayama Y, Okamoto D, Ushijima Y, Nishie A, Ishigami K, Takayama Y, Fujita N, Honda H
Department of Advanced Imaging and Interventional Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Clin Radiol. 2017 Sep;72(9):780-785. doi: 10.1016/j.crad.2017.03.023. Epub 2017 Apr 22.
To identify predictors of a therapeutic effect after transarterial chemoembolisation using drug-eluting beads (DEB-TACE) for hepatocellular carcinoma (HCC).
Between January 2015 and July 2015, tumour variables and angiographic data were collected for 25 patients (49 target lesions) after they had undergone the DEB-TACE procedure for HCC. The therapeutic effect was evaluated according to the Response Evaluation Criteria in Cancer of the Liver at follow-up dynamic computed tomography (CT) performed within 1-4 months after the procedure. A p<0.05 was considered significant.
On a target lesion basis, the objective response (TE3/4) rate was 63.3% (31 of 49). On univariate analysis, larger size (≥2 cm) was a predictor of an objective response (p=0.029). The tumour location of the medial (segment 4) or caudate (segment 1) lobe also indicated a poor therapeutic effect (TE1/2), but not at the level of significance (p=0.051). Multivariate analysis identified tumour size (odds ratio, 8.60; 95% confidence interval, 1.87-62.8) and tumour location (odds ratio, 12.2; 95% confidence interval, 2.12-129.8) as significant factors associated with a therapeutic effect. On a patient basis, 10 of 25 (40%) patients showed complete response/partial response. There were no significant differences between complete response/partial response and stable disease/progressive disease regarding age, gender, tumour markers, history of previous treatment, Child-Pugh class, T-stage, or Barcelona Clinic Liver Cancer Staging.
A short-term therapeutic effect was associated with tumour size and location on a target lesion basis.
确定使用载药微球经动脉化疗栓塞术（DEB-TACE）治疗肝细胞癌（HCC）后治疗效果的预测因素。
2015年1月至2015年7月期间，收集了25例接受HCC的DEB-TACE手术后的患者（49个靶病变）的肿瘤变量和血管造影数据。在手术后1-4个月内进行的随访动态计算机断层扫描（CT）中，根据肝癌反应评估标准评估治疗效果。p<0.05被认为具有统计学意义。
以靶病变为基础，客观缓解（TE3/4）率为63.3%（49个中的31个）。单因素分析显示，较大尺寸（≥2 cm）是客观缓解的预测因素（p=0.029）。内侧（第4段）或尾状叶（第1段）的肿瘤位置也显示治疗效果较差（TE1/2），但未达到显著水平（p=0.051）。多因素分析确定肿瘤大小（比值比，8.60；95%置信区间，1.87-62.8）和肿瘤位置（比值比，12.2；95%置信区间，2.12-129.8）是与治疗效果相关的显著因素。以患者为基础，25例患者中有10例（40%）显示完全缓解/部分缓解。在年龄、性别、肿瘤标志物、既往治疗史、Child-Pugh分级、T分期或巴塞罗那临床肝癌分期方面，完全缓解/部分缓解与疾病稳定/进展之间无显著差异。
基于靶病变，短期治疗效果与肿瘤大小和位置有关。
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