Liu Yi-Sheng, Lin Chia-Ying, Chuang Ming-Tsung, Lin Chia-Ying, Tsai Yi-Shan, Wang Chien-Kuo, Ou Ming-Ching
Department of Diagnostic Radiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138 Sheng Li Road, Tainan, 704, Taiwan, Republic of China.
BMC Gastroenterol. 2018 Aug 3;18(1):124. doi: 10.1186/s12876-018-0848-1.
Currently, no standard of care or therapies have been established for patients with advanced HCC. We evaluated the efficacy and safety of conventional transarterial chemoembolization using gelatin sponges or microspheres plus lipiodol-doxorubicin (cTACE) and TACE with doxorubicin-loaded drug eluting beads (DEB-TACE).
This retrospective study included 273 patients who received cTACE (n = 201) or DEB-TACE. Tumor response, survival, and adverse events were evaluated over a 5-year follow-up period.
During 5-year follow-up, a greater percentage of patients treated with cTACE died than those treated with DEB-TACE (76.1% vs. 66.7%) (P = 0.045). At the last evaluation, all surviving patients had disease progression and no differences were seen between treatment groups. However, the time to disease progression differed between groups; median time to disease progression was 11.0 months for cTACE and 16.0 months for DEB-TACE (P = 0.019). The median survival time was 37 months in both treatment groups. No significant differences were observed between cTACE and DEB-TACE therapies in subgroups of patients with BCLC stage A or stage B + C either in survival time or time to disease progression (P values > 0.05). No significant differences were observed in survival status or disease progression between cTACE and DEB-TACE in patient subgroups with either tumor number > 5 or with the sum of the diameter of largest five HCC tumors being > 7 cm.
DEB-TACE demonstrates greater long-term benefits than cTACE in treating treatment-naïve patients with HCC. Results of this long-term study support the use of DEB-TACE in treating HCC.
目前，对于晚期肝癌患者尚未确立标准治疗方案或疗法。我们评估了使用明胶海绵或微球加碘油-阿霉素的传统经动脉化疗栓塞术（cTACE）和载阿霉素药物洗脱微球经动脉化疗栓塞术（DEB-TACE）的疗效和安全性。
这项回顾性研究纳入了273例接受cTACE（n = 201）或DEB-TACE治疗的患者。在5年随访期内评估肿瘤反应、生存率和不良事件。
在5年随访期间，接受cTACE治疗的患者死亡百分比高于接受DEB-TACE治疗的患者（76.1%对66.7%）（P = 0.045）。在最后一次评估时，所有存活患者均有疾病进展，各治疗组之间未见差异。然而，两组之间疾病进展时间不同；cTACE的疾病进展中位时间为11.0个月，DEB-TACE为16.0个月（P = 0.019）。两个治疗组的中位生存时间均为37个月。在BCLC A期或B + C期患者亚组中，cTACE和DEB-TACE疗法在生存时间或疾病进展时间方面均未观察到显著差异（P值>0.05）。在肿瘤数量>5个或最大的5个肝癌肿瘤直径之和>7 cm的患者亚组中，cTACE和DEB-TACE在生存状态或疾病进展方面未观察到显著差异。
在治疗初治肝癌患者时，DEB-TACE比cTACE具有更大的长期益处。这项长期研究的结果支持使用DEB-TACE治疗肝癌。
