Lima Mariana, Dutra Sofia, Gomes Filipe Veloso, Bilhim Tiago, Coimbra Élia
Serviço de Imagiologia. Hospital de Santo António dos Capuchos. Centro Hospitalar de Lisboa Central. Lisboa. Portugal.
Serviço de Imagiologia. Hospital do Divino Espírito Santo. Ponta Delgada. Açores. Portugal.
Acta Med Port. 2018 Jan 31;31(1):22-29. doi: 10.20344/amp.8976.
Hepatic transarterial chemoembolization is a widely used technique for the treatment of hepatocellular carcinoma. The most common complication of this procedure is postembolization syndrome. The main objective of this study was to assess risk factors for the development of postembolization syndrome.
Single-centre retrospective analysis of 563 hepatic transarterial chemoembolization procedures from January 1st, 2014 - December 31st, 2015. Hepatic transarterial chemoembolization was performed with ½ - 2 vials of 100 - 300 μm microspheres loaded with doxorubicin. Patients who experienced postembolization syndrome were identified based on prolongation of hospitalization due to pain, fever, nausea and/or vomiting. A control group with the patients who did not have postembolization syndrome was randomly created (three controls for one case). Descriptive analysis and multivariate logistic regression were performed.
The overall prevalence of postembolization syndrome was 6.2%. Hepatic transarterial chemoembolization with doxorubicin dosage above 75 mg (more than one vial), the size of the largest nodule and female gender had statistically significant relation with development of postembolization syndrome (p = 0.030, p = 0.046 and p = 0.037, respectively).
Doxorrubicin dosage above 75 mg is associated with a higher risk of postembolization syndrome. This result can be helpful for decision-making in clinical practice, whenever it is possible to avoid a higher dose without compromising the efficacy of the treatment. The size of the largest nodule and female gender also constitute risk factors for postembolization syndrome. The other variables studied were not related to the development of postembolization syndrome.
The dose of doxorrubicin, the size of the largest nodule treated and female gender are potential risk factors for the development of postembolization syndrome after hepatic transarterial chemoembolization for hepatocellular carcinoma.
肝动脉化疗栓塞术是治疗肝细胞癌广泛应用的技术。该手术最常见的并发症是栓塞后综合征。本研究的主要目的是评估栓塞后综合征发生的危险因素。
对2014年1月1日至2015年12月31日期间563例肝动脉化疗栓塞术进行单中心回顾性分析。肝动脉化疗栓塞术使用1 - 2瓶装载阿霉素的100 - 300μm微球进行。根据因疼痛、发热、恶心和/或呕吐导致住院时间延长来确定发生栓塞后综合征的患者。随机设立未发生栓塞后综合征患者的对照组（一例患者对应三个对照组）。进行描述性分析和多因素逻辑回归分析。
栓塞后综合征的总体患病率为6.2%。阿霉素剂量超过75mg（超过一瓶）、最大结节大小和女性性别与栓塞后综合征的发生具有统计学显著相关性（分别为p = 0.030、p = 0.046和p = 0.037）。
阿霉素剂量超过75mg与栓塞后综合征的较高风险相关。该结果有助于临床实践中的决策，只要有可能在不影响治疗效果的情况下避免使用更高剂量。最大结节大小和女性性别也是栓塞后综合征的危险因素。所研究的其他变量与栓塞后综合征的发生无关。
阿霉素剂量、所治疗最大结节的大小和女性性别是肝细胞癌肝动脉化疗栓塞术后发生栓塞后综合征的潜在危险因素。
