Hatanaka Takeshi, Arai Hirotaka, Shibasaki Mitsuhiko, Tojima Hiroki, Takizawa Daichi, Toyoda Mitsuo, Takayama Hisashi, Abe Takehiko, Sato Ken, Kakizaki Satoru
Dept. of Gastroenterology, Maebashi Red Cross Hospital.
Gan To Kagaku Ryoho. 2018 Sep;45(9):1291-1296.
We previously reported that the antitumor response of balloon-occluded transcatheter arterial chemoembolization(BTACE) is better than that of conventional transcatheter arterial chemoembolization(C-TACE). Thus far, little attention has been paid on the efficacy of B-TACE using the same antitumor agents for hepatocellular carcinoma(HCC)that is unresponsive to C-TACE, which is defined as C50% necrosis of the targeted nodules or the appearance of new lesions in the liver 1-3 months following one C-TACE procedure. Therefore, this study focused on the efficacy of B-TACE using the same antitumor agents for HCC that is unresponsive to C-TACE. Fourteen patients treated with B-TACE at our institution were retrospectively investigated between January 2011 and August 2015. The median age was 76(interquartile range[IQR]70-79)years, and 9 patients(64.3%)were men. A total of 9(64.3%)and 5(35.7%)patients had the Child-Pugh class A and B, respectively. The median maximum tumor diameter was 30(IQR 18-40)mm, and 4(28.6%), 3(21.4%), 0(0.0%), and 7(50.0%) patients had 1, 2, 3, andB4 tumors, respectively. The antitumor effects were CR, PR, SD, and PD in 6(42.9%), 1(7.1%), 3 (21.4%), and 7(28.6%)patients, respectively. The response and disease control rates were 50% and 71.4%, respectively. Our results suggest that B-TACE is an effective modality for the treatment of HCC that is unresponsive to C-TACE.
我们之前报道过，球囊闭塞经导管动脉化疗栓塞术（BTACE）的抗肿瘤反应优于传统经导管动脉化疗栓塞术（C-TACE）。迄今为止，对于使用相同抗肿瘤药物的BTACE治疗对C-TACE无反应的肝细胞癌（HCC）的疗效关注甚少，这里将对C-TACE无反应定义为在一次C-TACE治疗后1至3个月，目标结节坏死率<50%或肝脏出现新病灶。因此，本研究聚焦于使用相同抗肿瘤药物的BTACE治疗对C-TACE无反应的HCC的疗效。回顾性调查了2011年1月至2015年8月间在我院接受BTACE治疗的14例患者。中位年龄为76（四分位间距[IQR]70 - 79）岁，9例（64.3%）为男性。分别有9例（64.3%）和5例（35.7%）患者为Child-Pugh A级和B级。最大肿瘤直径中位数为30（IQR 18 - 40）mm，分别有4例（28.6%）、3例（21.4%）、0例（0.0%）和7例（50.0%）患者有1个、2个、3个和≥4个肿瘤。抗肿瘤效果分别为完全缓解（CR）6例（42.9%）、部分缓解（PR）1例（7.1%）、疾病稳定（SD）3例（21.4%）和疾病进展（PD）7例（28.6%）。缓解率和疾病控制率分别为50%和71.4%。我们的结果表明，BTACE是治疗对C-TACE无反应的HCC的有效方式。
