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367 例肝癌患者中 CalliSpheres 载药微球栓塞化疗的疗效和安全性综合分析:一项多中心队列研究。

The Comprehensive Analysis of Efficacy and Safety of CalliSpheres Drug-Eluting Beads Transarterial Chemoembolization in 367 Liver Cancer Patients: A Multiple-Center, Cohort Study.

机构信息

Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityHangzhouChina.

Department of Radiology, Shulan (Hangzhou) Hospital, Zhejiang University International HospitalHangzhouChina.

出版信息

Oncol Res. 2020 May 29;28(3):249-271. doi: 10.3727/096504019X15766663541105. Epub 2019 Dec 19.

Abstract

This study aimed to investigate the efficacy, safety, and prognostic factors of drug-eluting beads transarterial chemoembolization (DEB-TACE) in treating Chinese patients with liver cancer. A total of 367 liver cancer patients from 24 medical centers were consecutively enrolled in this multiple-center, prospective cohort study, including 275 hepatocellular carcinoma (HCC) cases, 37 intrahepatic cholangiocarcinoma (ICC) cases, and 55 secondary liver cancer cases. All the patients received CalliSpheres DEB-TACE treatment. Treatment response, overall survival (OS), change of liver function, and adverse events (AEs) were assessed. DEB-TACE treatment achieved 19.9% complete response (CR) and 79.6% objective response rate (ORR), with mean OS of 384 days [95% confidence interval (CI): 375-393 days]. CR and ORR were both higher in HCC patients compared with primary ICC patients and secondary liver cancer patients, while no difference was discovered in OS. Portal vein invasion was an independent risk factor for CR, while portal vein invasion, previous conventional TACE (cTACE) treatment, and abnormal blood creatinine (BCr) were independent risk factors for ORR. In addition, largest nodule size ≥5.0 cm, abnormal albumin (ALB), and abnormal total bilirubin (TBIL) independently correlated with unfavorable OS. Most liver function indexes were recovered to baseline levels at 1-3 months after DEB-TACE. Common AEs were pain, fever, vomiting, and nausea; most of them were at mild grade. CalliSpheres DEB-TACE is efficient and well tolerated in Chinese liver cancer patients. Portal vein invasion, previous cTACE treatment, largest nodule size, abnormal BCr, ALB, and TBIL correlate with worse prognosis independently.

摘要

这项研究旨在探讨载药微球动脉化疗栓塞术(DEB-TACE)治疗中国肝癌患者的疗效、安全性和预后因素。这项多中心前瞻性队列研究共纳入了 24 家医疗中心的 367 例肝癌患者,包括 275 例肝细胞癌(HCC)、37 例肝内胆管癌(ICC)和 55 例继发性肝癌。所有患者均接受 CalliSpheres DEB-TACE 治疗。评估治疗反应、总生存期(OS)、肝功能变化和不良反应(AE)。DEB-TACE 治疗的完全缓解(CR)率为 19.9%,客观缓解率(ORR)为 79.6%,中位 OS 为 384 天[95%置信区间(CI):375-393 天]。HCC 患者的 CR 和 ORR 均高于原发性 ICC 患者和继发性肝癌患者,而 OS 无差异。门静脉侵犯是 CR 的独立危险因素,而门静脉侵犯、既往常规 TACE(cTACE)治疗和异常血肌酐(BCr)是 ORR 的独立危险因素。此外,最大结节直径≥5.0 cm、白蛋白(ALB)异常和总胆红素(TBIL)异常与不良 OS 独立相关。DEB-TACE 后 1-3 个月,大多数肝功能指标恢复至基线水平。常见的 AE 有疼痛、发热、呕吐和恶心,大多数为轻度。CalliSpheres DEB-TACE 治疗中国肝癌患者有效且耐受性良好。门静脉侵犯、既往 cTACE 治疗、最大结节直径、异常 BCr、ALB 和 TBIL 与独立预后不良相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f41e/7851534/85b5d36175b7/OR-28-249-g001.jpg

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