射频消融联合溶热敏感脂质体阿霉素：探寻治疗中等大小肝细胞癌的最佳方法
RFA plus lyso-thermosensitive liposomal doxorubicin: in search of the optimal approach to cure intermediate-size hepatocellular carcinoma.
作者信息
Lencioni Riccardo, Cioni Dania
机构信息
Department of Radiology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
出版信息
Hepat Oncol. 2016 Aug;3(3):193-200. doi: 10.2217/hep-2016-0005. Epub 2016 Jun 10.
Abstract
When heated during a radiofrequency ablation (RFA) procedure to ≥40°C, lyso-thermosensitive liposomal doxorubicin (LTLD) produces high drug concentration in the surrounding margins of the ablation zone. The hypothesis that the RFA + LTLD combination can effectively treat hepatocellular carcinoma (HCC) was investigated in the HEAT study: adding LTLD did not improve the efficacy of normal practice RFA. However, among the 285 patients with a solitary lesion who received at least 45-min RFA dwell time, the hazard ratio for overall survival was 0.63 (95% CI: 0.41-0.96; p = 0.04). The OPTIMA study is currently ongoing to test the hypothesis that adding LTLD to a standardized RFA lasting ≥45 min increases survival compared with standardized RFA alone.
摘要
在射频消融（RFA）手术过程中，当加热至≥40°C时，溶热敏感脂质体阿霉素（LTLD）会在消融区周边产生高药物浓度。在HEAT研究中，对RFA + LTLD联合治疗可有效治疗肝细胞癌（HCC）这一假设进行了研究：添加LTLD并未提高常规RFA的疗效。然而，在285例接受至少45分钟RFA驻留时间的单发病变患者中，总生存的风险比为0.63（95%置信区间：0.41 - 0.96；p = 0.04）。OPTIMA研究目前正在进行，以验证与单独的标准化RFA相比，在持续≥45分钟的标准化RFA中添加LTLD是否能提高生存率这一假设。
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