Ma Yilong, Zhao Chang, Zhao Hui, Li Haiping, Chen Changyong, Xiang Hua, Zheng Chuansheng, Ma Cong, Luo Chao, Qiu Huaiming, Yao Yuanhui, Hu Hongyao, Xiong Bin, Zhou Jun, Zhu Hui, Long Qingyun
Department of Interventional Therapy, Guangxi Medical University Affiliated Tumor Hospital China.
Department of Radiology, Renmin Hospital of Wuhan University, Hubei General Hospital China.
Am J Transl Res. 2019 Dec 15;11(12):7456-7470. eCollection 2019.
We aimed to compare the treatment response, survivals and safety of drug-eluting bead (DEB) transarterial chemoembolization (TACE) with CalliSpheres microspheres (CSM) and conventional TACE (cTACE) as first-line treatment in Chinese HCC patients. 192 HCC patients from multiple centers received DEB-TACE with CSM or cTACE treatment as first-line treatment were included and assigned to DEB-TACE group (N=94) or cTACE group (N=98) accordingly. Treatment response was assessed at 1 month (M1), M3 and M6 after treatment. Progression-free survival (PFS) and overall survival (OS) was evaluated. Liver function indexes and adverse events were recorded. Complete response (CR) and objective response rate (ORR) were higher, while disease control rate (DCR) rate was similar in DEB-TACE group compared with cTACE group, and further multivariate logistic regression analysis validated that DEB-TACE vs cTACE independently predicted higher ORR. For survivals, no difference in PFS or OS was observed between DEB-TACE and cTACE groups, and multivariate Cox's proportional hazards regression revealed that DEB-TACE vs cTACE was not correlated with PFS or OS either. Additionally, no difference in liver function indexes at M1 or changes of liver function indexes from M0 to M1 between DEB-TACE and cTACE groups after treatment was observed, whereas DEB-TACE resulted in higher incidence of pain and fever during treatment or hospitalization. DEB-TACE with CSM discloses better treatment response, similar survival profiles and equal liver function injury but increased incidence of short-term adverse events than cTACE as the first-line therapy in treating HCC patients.
我们旨在比较载药微球(DEB)经动脉化疗栓塞术(TACE)联合恒瑞艾瑞柯微球(CSM)与传统TACE(cTACE)作为中国肝癌患者一线治疗的疗效、生存率和安全性。纳入了来自多个中心的192例接受DEB-TACE联合CSM或cTACE一线治疗的肝癌患者,并相应地分为DEB-TACE组(N = 94)或cTACE组(N = 98)。在治疗后1个月(M1)、M3和M6评估治疗反应。评估无进展生存期(PFS)和总生存期(OS)。记录肝功能指标和不良事件。与cTACE组相比,DEB-TACE组的完全缓解(CR)和客观缓解率(ORR)更高,而疾病控制率(DCR)相似,进一步的多因素逻辑回归分析证实,DEB-TACE与cTACE相比独立预测更高的ORR。在生存率方面,DEB-TACE组和cTACE组在PFS或OS上未观察到差异,多因素Cox比例风险回归显示,DEB-TACE与cTACE也与PFS或OS无关。此外,治疗后DEB-TACE组和cTACE组在M1时的肝功能指标或从M0到M1的肝功能指标变化无差异,而DEB-TACE在治疗或住院期间导致疼痛和发热的发生率更高。作为治疗肝癌患者的一线治疗,DEB-TACE联合CSM显示出比cTACE更好的治疗反应、相似的生存情况和同等的肝功能损伤,但短期不良事件的发生率增加。