Interventional Radiology Department, The First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310006, China.
Department of Radiology, Hangzhou Cancer Hospital, No. 34 Yan Guan lane, Hangzhou, China.
Clin Transl Oncol. 2019 Feb;21(2):167-177. doi: 10.1007/s12094-018-1902-8. Epub 2018 Jul 12.
To assess the efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) in liver cancer patients with different times of previous conventional transarterial chemoembolization (cTACE) treatments.
367 liver cancer patients about to receive DEB-TACE treatment were enrolled in this prospective cohort study. All patients were divided into no previous cTACE group (NPC group), 1-2 times previous cTACE group (PC group) and triple or above previous cTACE group (TPC group) according to the times of previous cTACE treatments.
There was no difference in complete response (CR) (P = 0.671) and objective response rate (ORR) (P = 0.062) among three groups. Additionally, no difference in overall survival (OS) among groups (P = 0.899) was found. As to liver function, most liver function indexes were deteriorative at 1 week after DEB-TACE operation, but returned to baseline at 1-3 months after DEB-TACE operation in all three groups, while percentage of abnormal total bile acid (TBA) patients was higher in TPC group than NPC and PC groups at 1-3 month post-DEB-TACE (P = 0.018). As for safety profiles, the incidence of pain during DEB-TACE operation was lower in TPC group compared to NPC and PC groups (P = 0.005), while no difference of other adverse events was found during and 1 month post-DEB-TACE treatment among three groups.
DEB-TACE treatment was equally efficient and tolerated in liver cancer patients with different times of previous cTACE treatments.
评估载药微球动脉化疗栓塞术(DEB-TACE)治疗不同次数经导管肝动脉化疗栓塞术(cTACE)治疗肝癌患者的疗效和安全性。
本前瞻性队列研究纳入了 367 例即将接受 DEB-TACE 治疗的肝癌患者。所有患者根据 cTACE 治疗次数分为无 cTACE 治疗史组(NPC 组)、1-2 次 cTACE 治疗史组(PC 组)和 3 次及以上 cTACE 治疗史组(TPC 组)。
三组间完全缓解率(CR)(P=0.671)和客观缓解率(ORR)(P=0.062)无差异。此外,三组间总生存期(OS)无差异(P=0.899)。肝功能方面,三组患者在 DEB-TACE 术后 1 周时多数肝功能指标恶化,但在 DEB-TACE 术后 1-3 个月时均恢复至基线水平,而 TPC 组在 DEB-TACE 术后 1-3 个月时总胆汁酸(TBA)异常患者比例高于 NPC 组和 PC 组(P=0.018)。安全性方面,TPC 组患者在 DEB-TACE 手术过程中的疼痛发生率低于 NPC 组和 PC 组(P=0.005),而三组患者在 DEB-TACE 治疗期间和治疗后 1 个月的其他不良事件发生率无差异。
对于不同次数经导管肝动脉化疗栓塞术治疗的肝癌患者,载药微球动脉化疗栓塞术的疗效和耐受性相当。