Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.
School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Sci Rep. 2019 Dec 27;9(1):20032. doi: 10.1038/s41598-019-56545-1.
Drug-eluting microsphere transarterial chemoembolization (DEM-TACE) has been introduced to ensure more sustained and tumor-selective drug delivery for permanent embolization of HCC. The aim of this study was to determine the imaging characteristics that related to favourable treatment response in BCLC-C HCC patients treated with DEM-TACE. In total, 64 patients with BCLC-C HCC that treated with DEM-TACE using doxorubicin-eluted microspheres were retrospectively included. The images were assessed at baseline and at 4-12 weeks follow-up after receiving DEM-TACE. Pre- and post-procedural imaging characteristics were analysed by two independent radiologists and treatment response was evaluated using the modified Response Evaluation Criteria in Solid Tumors criteria. Multivariate analysis showed that vascular lake phenomenon (OR = 5.94, p = 0.03*), and homogeneous tumor enhancement (HTE) on cone-beam computed tomography (CBCT) during angiography (OR = 11.66, p < 0.001*) are associated with better radiological response. In contrast, residual tumor blush (OR = 0.11, p < 0.001*) is associated with worse radiological response. In conclusion, the initial tumor burden <50% (p = 0.012*) and HTE on CBCT (p = 0.040*) are good predictors for locoregional tumor control in patients with advanced HCCs, which can potentially improve patients' outcome.
载药微球经动脉化疗栓塞术（DEM-TACE）已被引入，以确保更持续和肿瘤选择性的药物输送，用于 HCC 的永久性栓塞。本研究旨在确定与接受 DEM-TACE 治疗的 BCLC-C HCC 患者良好治疗反应相关的影像学特征。共纳入 64 例接受多柔比星洗脱微球治疗的 BCLC-C HCC 患者。在接受 DEM-TACE 治疗后 4-12 周进行基线和随访。由两位独立的放射科医生评估术前和术后的影像学特征，并使用改良实体瘤反应评价标准（mRECIST）评价治疗反应。多变量分析显示，血管湖现象（OR=5.94，p=0.03*）和锥形束 CT（CBCT）血管造影期间的均匀肿瘤增强（HTE）（OR=11.66，p<0.001*）与更好的影像学反应相关。相反，残留肿瘤染色（OR=0.11，p<0.001*）与较差的影像学反应相关。总之，初始肿瘤负担<50%（p=0.012*）和 CBCT 上的 HTE（p=0.040*）是预测晚期 HCC 患者局部肿瘤控制的良好指标，这可能会改善患者的预后。
