Department of Radiology, Division of Interventional Radiology, University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN, 55455, USA.
Eur Radiol. 2019 Jun;29(6):3287-3295. doi: 10.1007/s00330-018-5782-7. Epub 2018 Oct 22.
Despite being accepted as a mainstay of treatment for hepatocellular carcinoma (HCC), technical aspects of transarterial chemoembolization (TACE) continue to vary by reporting author, leading to heterogeneity in the literature and making meaningful comparisons between treatments difficult. The goal of this survey was to report international chemoembolization practices for the treatment of HCC in an effort to understand current treatment strategies as a first step towards technique standardization.
An anonymous 18-question online survey, evaluating technical aspects of their TACE practice, was distributed via email to practicing members of the five largest interventional radiology societies in Chinese and English. A total of 1160 responses were obtained from 62 countries. Responses were categorized according to region of practice and analyzed using Fisher's exact test and chi-square test with Bonferroni correction as needed.
There were significant statistical differences between regions for nearly all questions. Doxorubicin was more commonly used among respondents from North America, Europe, and South Korea than Japan and China (p = 0.0001). For single and multiple HCCs, drug-eluting bead TACE was most popular in North America and Europe (p = 0.0001), while conventional TACE was most popular in Japan, Korea, and China (p = 0.0001). CT was the most commonly used modality for follow-up among all respondents, although MR was used more commonly in North America and in academic centers (p = 0.0001).
This survey provides comprehensive information on and confirms the heterogeneous nature of current practice patterns in regard to TA(C)E for HCC.
• There is a lack of information regarding current practice patterns in the area of technical considerations when performing transarterial chemoembolization. • Type of transarterial chemoembolization utilized to treat hepatocellular carcinoma varies widely across geographical area. • Chemotherapeutic agents and embolic agents used to perform transarterial chemoembolization for the treatment of hepatocellular carcinoma vary widely across geographical areas.
尽管经动脉化疗栓塞术（TACE）已被接受为肝细胞癌（HCC）的主要治疗方法，但 TACE 的技术方面仍因报告作者而异，导致文献存在异质性，使治疗之间的比较变得困难。本调查的目的是报告国际 TACE 治疗 HCC 的实践，旨在了解当前的治疗策略，作为技术标准化的第一步。
通过电子邮件向中文和英文五个最大的介入放射学学会的执业成员分发了一份匿名的 18 个问题的在线调查，评估他们 TACE 实践的技术方面。共从 62 个国家获得了 1160 份回复。根据实践区域对回复进行分类，并使用 Fisher 精确检验和卡方检验进行分析，必要时使用 Bonferroni 校正。
几乎所有问题的区域之间都存在显著的统计学差异。与日本和中国相比，北美的受访者和欧洲以及韩国更常使用多柔比星（p = 0.0001）。对于单发和多发 HCC，药物洗脱珠 TACE 在北美和欧洲最受欢迎（p = 0.0001），而传统 TACE 在日本、韩国和中国最受欢迎（p = 0.0001）。CT 是所有受访者中最常用的随访方式，尽管北美和学术中心更常使用 MR（p = 0.0001）。
本调查提供了关于 HCC 的 TACE 当前实践模式的全面信息，并证实了其异质性。
关于执行 TACE 时的技术考虑因素，目前在实践模式方面缺乏信息。
用于治疗肝细胞癌的 TACE 类型在地理区域上差异很大。
用于进行 TACE 治疗肝细胞癌的化疗药物和栓塞剂在地理区域上差异很大。
