使用引导软件进行传统经动脉化疗栓塞治疗的肝细胞癌患者的治疗结果
Outcomes of Patients with Hepatocellular Carcinoma Treated with Conventional Transarterial Chemoembolization Using Guidance Software.
作者信息
Miyayama Shiro, Yamashiro Masashi, Sugimori Natsuki, Ikeda Rie, Okimura Kotaro, Sakuragawa Naoko
机构信息
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.
出版信息
J Vasc Interv Radiol. 2019 Jan;30(1):10-18. doi: 10.1016/j.jvir.2018.08.009.
PURPOSE
To evaluate the outcomes of conventional transarterial chemoembolization using guidance software for hepatocellular carcinoma (HCC) patients.
MATERIALS AND METHODS
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.
RESULTS
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).
CONCLUSIONS
Transarterial chemoembolization guidance software promotes the technical success of transarterial chemoembolization and excellent OS in HCC patients.
目的
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。
材料与方法
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。
结果
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）。
结论
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。
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