奥沙利铂、氟尿嘧啶和亚叶酸钙肝动脉灌注治疗伴肝外转移的肝细胞癌
Hepatic Arterial Infusion of Oxaliplatin, Fluorouracil, and Leucovorin in Hepatocellular Cancer with Extrahepatic Spread.
作者信息
Lyu Ning, Kong Yanan, Pan Tao, Mu Luwen, Li Shaolong, Liu Yaru, Deng Haijing, Li Jibin, Shi Ming, Xu Li, Guo Rongping, Chen Minshan, Wu Peihong, Zhao Ming
机构信息
Department of Minimally Invasive Interventional Radiology, Center of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong 510060, China.
Department of Breast Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong 510060, China.
出版信息
J Vasc Interv Radiol. 2019 Mar;30(3):349-357.e2. doi: 10.1016/j.jvir.2018.09.004.
PURPOSE
To compare treatment with hepatic arterial infusion of chemotherapy (HAIC) in patients with advanced hepatocellular carcinoma (HCC) with both extrahepatic spread (EHS) and intrahepatic tumor and patients with intrahepatic tumor only.
MATERIALS AND METHODS
This single-center retrospective study comprised 116 patients with advanced HCC with both intrahepatic tumor and EHS (EHS group; n = 50) or with intrahepatic tumor only (non-EHS group; n = 66) treated with HAIC including oxaliplatin, fluorouracil, and leucovorin between June 2014 and July 2016. Overall survival (OS) and radiologic responses to treatment were determined and compared between the 2 groups.
RESULTS
Both the objective response rate and the clinical benefit rate were higher in the non-EHS group than in the EHS group (37.9% vs 16% objective response rate, P = .010; 81.8% vs 62% clinical benefit rate, P = .017). Median OS was not statistically different between the 2 groups (14.8 months vs 9.8 months, P = .068). Subgroup analysis of OS found that patients with lung metastases survived for a shorter time (OS 7 months) than patients with other metastatic sites (P = .003) and patients free of metastases (P = .001).
CONCLUSIONS
HAIC is a potential treatment option for advanced HCC with limited extrahepatic metastases in a population with hepatitis B virus infection.
目的
比较肝动脉灌注化疗（HAIC）对伴有肝外转移（EHS）和肝内肿瘤的晚期肝细胞癌（HCC）患者与仅伴有肝内肿瘤的患者的治疗效果。
材料与方法
这项单中心回顾性研究纳入了2014年6月至2016年7月期间接受HAIC（包括奥沙利铂、氟尿嘧啶和亚叶酸钙）治疗的116例伴有肝内肿瘤和EHS的晚期HCC患者（EHS组；n = 50）或仅伴有肝内肿瘤的患者（非EHS组；n = 66）。确定并比较两组的总生存期（OS）和治疗的放射学反应。
结果
非EHS组的客观缓解率和临床获益率均高于EHS组（客观缓解率37.9%对16%，P = .010；临床获益率81.8%对62%，P = .017）。两组的中位OS无统计学差异（14.8个月对9.8个月，P = .068）。OS的亚组分析发现，肺转移患者的生存期（OS 7个月）短于其他转移部位患者（P = .003）和无转移患者（P = .001）。
结论
HAIC是乙型肝炎病毒感染人群中伴有有限肝外转移的晚期HCC的一种潜在治疗选择。
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