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与传统经动脉化疗栓塞术相比,载药微球经导管动脉化疗栓塞术治疗肝细胞癌患者疗效更佳且安全性相当。

CalliSpheres Drug-Eluting Bead Transcatheter Arterial Chemoembolization Presents With Better Efficacy and Equal Safety Compared to Conventional TACE in Treating Patients With Hepatocellular Carcinoma.

作者信息

Xiang Hua, Long Lin, Yao Yuanhui, Fang Zhiyong, Zhang Zhiming, Zhang Yongjin

机构信息

1 Department of Interventional Radiology & Vascular Surgery, Hunan Provincial People's Hospital, Changsha, Hunan, China.

出版信息

Technol Cancer Res Treat. 2019 Jan 1;18:1533033819830751. doi: 10.1177/1533033819830751.

Abstract

The aim of this study was to compare the treatment response, survival, liver function, and adverse event incidence of drug-eluting bead transcatheter arterial chemoembolization using CalliSpheres microspheres with conventional transcatheter arterial chemoembolization in patients with hepatocellular carcinoma. Seventy-three patients with hepatocellular carcinoma who received drug-eluting bead transcatheter arterial chemoembolization (using CalliSpheres microspheres) or conventional transcatheter arterial chemoembolization treatment were consecutively enrolled. Treatment response was assessed by modified Response Evaluation Criteria in Solid Tumors at month 1/month 3/month 6; posttreatment, liver function indexes, and adverse events were recorded. Progression-free survival and overall survival were also calculated. Objective response rate of patients at months 1, 3, and 6, disease control rate of patients and objective response rate of nodules at month 3 were increased in drug-eluting bead transcatheter arterial chemoembolization group compared with conventional transcatheter arterial chemoembolization group. In addition, drug-eluting bead transcatheter arterial chemoembolization using CalliSpheres microspheres was an independent factor for predicting better objective response rate at month 1. Patients in drug-eluting bead transcatheter arterial chemoembolization group achieved longer progression-free survival and similar overall survival compared to those in conventional transcatheter arterial chemoembolization group; Cox proportional hazards regression model analyses revealed that drug-eluting bead transcatheter arterial chemoembolization using CalliSpheres microspheres was associated with better progression-free survival while it did not affect overall survival. Meanwhile, most of the occurrences of abnormal liver function indexes were similar between 2 groups, whereas drug-eluting bead transcatheter arterial chemoembolization group had a higher percentage of patients with total bile acid ≥2 upper limit of normal compared to conventional transcatheter arterial chemoembolization group at month 1. Moreover, the adverse event incidences between 2 groups were similar. In conclusion, drug-eluting bead transcatheter arterial chemoembolization using CalliSpheres microspheres achieves better treatment response and progression-free survival while equal safety compared to conventional transcatheter arterial chemoembolization in patients with hepatocellular carcinoma.

摘要

本研究旨在比较使用载药微球(CalliSpheres微球)的药物洗脱微球经导管动脉化疗栓塞术与传统经导管动脉化疗栓塞术在肝细胞癌患者中的治疗反应、生存率、肝功能及不良事件发生率。连续纳入73例接受药物洗脱微球经导管动脉化疗栓塞术(使用CalliSpheres微球)或传统经导管动脉化疗栓塞术治疗的肝细胞癌患者。在第1个月/第3个月/第6个月时,采用改良实体瘤疗效评价标准评估治疗反应;记录治疗后肝功能指标及不良事件。计算无进展生存期和总生存期。与传统经导管动脉化疗栓塞术组相比,药物洗脱微球经导管动脉化疗栓塞术组患者在第1、3和6个月时的客观缓解率、患者疾病控制率以及第3个月时结节的客观缓解率均有所提高。此外,使用CalliSpheres微球的药物洗脱微球经导管动脉化疗栓塞术是预测第1个月时更好客观缓解率的独立因素。与传统经导管动脉化疗栓塞术组相比,药物洗脱微球经导管动脉化疗栓塞术组患者的无进展生存期更长,总生存期相似;Cox比例风险回归模型分析显示,使用CalliSpheres微球的药物洗脱微球经导管动脉化疗栓塞术与更好的无进展生存期相关,而对总生存期无影响。同时,两组肝功能指标异常的发生率大多相似,但在第1个月时,药物洗脱微球经导管动脉化疗栓塞术组总胆汁酸≥正常上限2倍的患者比例高于传统经导管动脉化疗栓塞术组。此外,两组不良事件发生率相似。总之,与传统经导管动脉化疗栓塞术相比,使用CalliSpheres微球的药物洗脱微球经导管动脉化疗栓塞术在肝细胞癌患者中能取得更好的治疗反应和无进展生存期,且安全性相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccb7/6416678/24d048d6f16e/10.1177_1533033819830751-fig1.jpg

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