Miyayama Shiro, Yamashiro Masashi, Sugimori Natsuki, Ikeda Rie, Okimura Kotaro, Sakuragawa Naoko
Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, 7-1, Funabashi, Wadanaka-cho, Fukui 918-8503, Japan.
Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, 7-1, Funabashi, Wadanaka-cho, Fukui 918-8503, Japan.
J Vasc Interv Radiol. 2019 Jan;30(1):10-18. doi: 10.1016/j.jvir.2018.08.009.
To evaluate the outcomes of conventional transarterial chemoembolization using guidance software for hepatocellular carcinoma (HCC) patients.
One hundred two patients with treatment-naïve HCC with ≤ 7-cm and ≤ 5 lesions treated with conventional transarterial chemoembolization using guidance software were selected. Technical success was classified into 3 grades by computed tomography performed 1 week after transarterial chemoembolization: (i) A, complete embolization with a safety margin; (ii) B, entire tumor embolization without a safety margin; and (iii) C, incomplete embolization. Intrahepatic tumor recurrence was classified into 2 categories: local tumor progression (LTP) and intrahepatic distant recurrence (IDR). Overall survival (OS) and tumor recurrence rates were calculated by the Kaplan-Meier method. Additionally, the incidences of LTP between grade A and B tumors, IDR with/without LTP, and OS with/without LTP were compared by the log-rank test.
One hundred fifty-six (82.1%) tumors were determined to be grade A, 26 (13.7%) were determined to be grade B, and 8 (4.2%) were determined to be grade C. The 1-, 3-, and 5-year LTP and IDR rates were 31.7%, 49.4%, and 59.4% and 33.9%, 58.2%, and 73.3%, respectively. LTP developed more frequently in grade B tumors than grade A tumors (P = .0016). IDR developed more frequently in patients with LTP than without LTP (P = .0004). The 1-, 3-, and 5-year OS rates were 96.1%, 71.1%, and 60%, respectively; the 1-, 3-, and 5-year OS rates in patients with/without LTP were 95.7%, 69.8%, and 59.3% and 96.2%, 71.6%, and 59.4%, respectively (P = .9984).
Transarterial chemoembolization guidance software promotes the technical success of transarterial chemoembolization and excellent OS in HCC patients.
评估使用引导软件进行传统经动脉化疗栓塞术治疗肝细胞癌（HCC）患者的疗效。
选取102例初治的HCC患者，肿瘤直径≤7 cm且病灶数量≤5个，采用引导软件进行传统经动脉化疗栓塞术。经动脉化疗栓塞术后1周行计算机断层扫描，将技术成功分为3级：（i）A级，完全栓塞且有安全边缘；（ii）B级，肿瘤完全栓塞但无安全边缘；（iii）C级，不完全栓塞。肝内肿瘤复发分为2类：局部肿瘤进展（LTP）和肝内远处复发（IDR）。采用Kaplan-Meier法计算总生存期（OS）和肿瘤复发率。此外，通过对数秩检验比较A级和B级肿瘤的LTP发生率、有无LTP的IDR发生率以及有无LTP的OS发生率。
156个（82.1%）肿瘤判定为A级，26个（13.7%）判定为B级，8个（4.2%）判定为C级。1年、3年和5年的LTP率和IDR率分别为31.7%、49.4%、59.4%和33.9%、58.2%、73.3%。B级肿瘤的LTP发生率高于A级肿瘤（P = 0.0016）。有LTP的患者IDR发生率高于无LTP的患者（P = 0.0004）。1年、3年和5年的OS率分别为96.1%、71.1%和60%；有/无LTP患者的1年、3年和5年OS率分别为95.7%、69.8%、59.3%和96.2%、71.6%、59.4%（P = 0.9984）。
经动脉化疗栓塞术引导软件可提高经动脉化疗栓塞术的技术成功率，并使HCC患者获得良好的总生存期。
