Oncol Res Treat. 2018;41(7-8):438-442. doi: 10.1159/000488644. Epub 2018 Jul 16.
We evaluated survival data and local tumor control in 2 groups of patients with hepatocellular carcinoma (HCC) treated with different chemotherapeutic agents for transarterial chemoembolization (TACE).
28 patients (median age 63 years) with HCC were repeatedly treated with chemoembolization at 4-week intervals. 20 patients had Barcelona Clinic Liver Cancer (BCLC) stage B, while 8 patients obtained chemoembolization for bridging purposes (BCLC stage A). In total, 98 chemoembolizations were performed (median 3.0 treatments/patient). The administered chemotherapeutic agent comprised either mitomycin only (n = 14; 50%) or mitomycin in combination with irinotecan (n = 14; 50%). Lipiodol plus degradable starch microspheres was used for all embolizations. Local tumor response was assessed by magnetic resonance imaging using modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. Progression-free survival (PFS) was evaluated.
In the mitomycin-irinotecan group, complete response (CR) was observed in 21.4%, partial response (PR) in 42.9%, stable disease (SD) in 28.6%, and progressive disease (PD) in 7.1%. In the mitomycin group, PR was observed in 57.2% of patients, SD in 21.4%, and PD in 21.4% (p = 0.043). The PFS of patients after chemoembolization with mitomycin was 4 months compared to the significantly longer PFS of 12 months in the mitomycin-irinotecan group (p = 0.003).
Chemoembolization of HCC with mitomycin and irinotecan is the preferred treatment option for achieving local control and better PFS.
我们评估了两组接受不同化疗药物经动脉化疗栓塞（TACE）治疗的肝细胞癌（HCC）患者的生存数据和局部肿瘤控制情况。
28 例 HCC 患者（中位年龄 63 岁）每 4 周重复接受化疗栓塞治疗。20 例患者为巴塞罗那临床肝癌（BCLC）B 期，8 例患者接受化疗栓塞治疗用于桥接（BCLC 期 A）。共进行了 98 次化疗栓塞治疗（中位 3.0 次/例）。所用化疗药物为丝裂霉素单药（n = 14；50%）或丝裂霉素联合伊立替康（n = 14；50%）。所有栓塞均使用碘油加可降解淀粉微球。采用改良实体瘤反应评估标准（mRECIST）评估磁共振成像的局部肿瘤反应。评估无进展生存期（PFS）。
在丝裂霉素-伊立替康组中，完全缓解（CR）为 21.4%，部分缓解（PR）为 42.9%，疾病稳定（SD）为 28.6%，疾病进展（PD）为 7.1%。在丝裂霉素组中，PR 为 57.2%，SD 为 21.4%，PD 为 21.4%（p = 0.043）。丝裂霉素化疗栓塞后患者的 PFS 为 4 个月，而丝裂霉素-伊立替康组的 PFS 明显更长，为 12 个月（p = 0.003）。
丝裂霉素联合伊立替康化疗栓塞是实现局部控制和更好 PFS 的首选治疗方案。
