Department of Radiology, IGT Clinic, Image Guided Therapy, Osaka, Japan.
Department of Radiology, Kansai Rosai Hospital, Osaka, Japan.
Br J Radiol. 2020 Jun;93(1110):20190407. doi: 10.1259/bjr.20190407. Epub 2020 Mar 18.
To evaluate the feasibility, efficacy and safety of transcatheter arterial chemoembolization (TACE) with HepaSphere for patients with pulmonary or mediastinal metastases from hepatocellular carcinoma (HCC).
Between June 2009 and January 2018, 14 patients with pulmonary or mediastinal metastases from HCC were treated with TACE with a combination of 1-3 chemotherapeutic drugs followed by HepaSphere embolization. As first end point, local tumor response and adverse events were evaluated after the first session of TACE, with Response Evaluation Criteria In Solid Tumors v. 1.1 and Common Terminology Criteria for Adverse Events v. 4 criteria, respectively. Overall survival was evaluated as secondary end point. TACE was repeated on-demand.
TACE with HepaSphere was well tolerated with acceptable safety profile and no 30 day mortality. 1 month objective response and disease control rate were calculated to be 7.1 and 100%, respectively. Mean tumor size reduction rate was 15.6±9.5% at the first month. Two Grade 3 cytopenia events were seen (14.3 %), however none of the Grade 2 or more post-embolization syndrome was observed. The median overall survival time was 15.0 months and the 1 year, 3 year and 5 year survival rate were, 57.1%, 28.6%, 19.1%, respectively.
Early experience showed that the transarterial treatment with HepaSphere is safe and effective treatment for patients with pulmonary or mediastinal metastases from HCC.
Currently, the effects of molecular targeted drugs on HCC metastases are limited and side-effects are relatively frequent. In the present study, transarterial treatment might be a promising treatment for HCC metastasis.
评估经导管动脉化疗栓塞（TACE）联合 HepaSphere 治疗肝细胞癌（HCC）肺或纵隔转移的可行性、疗效和安全性。
2009 年 6 月至 2018 年 1 月，14 例 HCC 肺或纵隔转移患者接受了 TACE 联合 1-3 种化疗药物治疗，随后进行 HepaSphere 栓塞。以实体瘤反应评价标准 1.1 版（Response Evaluation Criteria In Solid Tumors v. 1.1）和不良事件通用术语标准 4 版（Common Terminology Criteria for Adverse Events v. 4）分别评估首次 TACE 后局部肿瘤反应和不良事件作为主要终点。以总生存期作为次要终点。按需重复 TACE。
HepaSphere 联合 TACE 耐受性良好，安全性可接受，无 30 天死亡率。1 个月时的客观缓解率和疾病控制率分别为 7.1%和 100%。平均肿瘤缩小率为 15.6±9.5%。观察到 2 例 3 级血细胞减少症（14.3%），但无观察到 2 级或更高级别的栓塞后综合征。中位总生存期为 15.0 个月，1 年、3 年和 5 年生存率分别为 57.1%、28.6%、19.1%。
早期经验表明，HepaSphere 经动脉治疗对 HCC 肺或纵隔转移患者是一种安全有效的治疗方法。
目前，分子靶向药物对 HCC 转移的疗效有限，且副作用相对频繁。在本研究中，经动脉治疗可能是 HCC 转移的一种有前途的治疗方法。
