Greco Giorgio, Cascella Tommaso, Facciorusso Antonio, Nani Roberto, Lanocita Rodolfo, Morosi Carlo, Vaiani Marta, Calareso Giuseppina, Greco Francesca G, Ragnanese Antonio, Bongini Marco A, Marchianò Alfonso V, Mazzaferro Vincenzo, Spreafico Carlo
Giorgio Greco, Tommaso Cascella, Rodolfo Lanocita, Carlo Morosi, Marta Vaiani, Giuseppina Calareso, Francesca G Greco, Alfonso V Marchianò, Carlo Spreafico, Department of Radiology, Interventional Radiology, Nuclear Medicine and Radiotherapy, National Cancer Institute, 20133 Milan, Italy.
World J Radiol. 2017 May 28;9(5):245-252. doi: 10.4329/wjr.v9.i5.245.
To assess the safety and efficacy of transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) using a new generation of 40 μm drug eluting beads in patients not eligible for curative treatment.
Drug eluting bead TACE (DEB-TACE) using a new generation of microspheres (embozene tandem, 40 μm) preloaded with 100 mg of doxorubicin was performed on 48 early or intermediate HCC patients with compensated cirrhosis. Response to therapy was assessed with Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST) guidelines applied to computed tomography or magnetic resonance imaging. Eleven out of the 48 treated patients treated progressed on to receive liver orthotopic transplantation (OLT). This allowed for histological analysis on the treated explanted nodules.
DEB-TACE with 40 μm showed a good safety profile without major complications or 30-d mortality. The objective response rate of treated tumors was 72.6% and 26.7% according to mRECIST and RECIST respectively. Histological examination in 11 patients assigned to OLT showed a necrosis degree > 90% in 78.6% of cases. The overall time to progression was 13 mo (11-21).
DEB-TACE with 40 μm particles is an effective treatment for the treatment of HCC in early-intermediate patients (Barcelona Clinic Liver Cancer stage A/B) with a good safety profile and good results in term of objective response rate and necrosis.
评估在无法接受根治性治疗的患者中，使用新一代40μm药物洗脱微球行经动脉化疗栓塞术（TACE）治疗肝细胞癌（HCC）的安全性和疗效。
对48例代偿期肝硬化的早期或中期HCC患者，采用预载100mg阿霉素的新一代微球（Embozene Tandem，40μm）进行药物洗脱微球TACE（DEB-TACE）治疗。根据实体瘤疗效评价标准（RECIST）和应用于计算机断层扫描或磁共振成像的改良RECIST（mRECIST）指南评估治疗反应。48例接受治疗的患者中有11例进展后接受了原位肝移植（OLT）。这使得能够对切除的治疗结节进行组织学分析。
40μm的DEB-TACE显示出良好的安全性，无严重并发症或30天死亡率。根据mRECIST和RECIST标准，治疗肿瘤的客观缓解率分别为72.6%和26.7%。11例接受OLT患者的组织学检查显示，78.6%的病例坏死程度>90%。总体疾病进展时间为13个月（11 - 21个月）。
40μm颗粒的DEB-TACE是治疗早期-中期患者（巴塞罗那临床肝癌分期A/B）HCC的有效方法，具有良好的安全性，在客观缓解率和坏死方面效果良好。
