Sichuan Key Laboratory of Medical Imaging, Department of Interventional Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China (mainland).
Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China (mainland).
Med Sci Monit. 2020 May 31;26:e922988. doi: 10.12659/MSM.922988.
BACKGROUND This study aimed to assess the relative safety and short-term efficacy of drug-eluting bead transarterial chemoembolization (DEB-TACE) and conventional transarterial chemoembolization (c-TACE) for treating peculiar anatomical sites of gastric cancer liver metastasis. MATERIAL AND METHODS Of the 68 patients with gastric cancer liver metastases confirmed by imaging and pathology, 35 were treated with DEB-TACE and 33 with c-TACE. The DEB-TACE group comprised 26 males and 9 females aged 28-75 years (56.8±6.3), and the c-TACE group included 19 males and 14 females aged 33-77 (60.2±9.4) years. Liver functions of the 2 groups were compared between pre-TACE and 1-week and 1-month after TACE. Computed tomography and magnetic resonance imaging were reexamined at 1, 3, and 6 months after TACE, and short-term efficacy was assessed based on modified response evaluation criteria in solid tumors. RESULTS One month following DEB-TACE and c-TACE, the number of cases with objective response (OR) was 29 cases (29 out of 35 cases, 82.9%) and 20 cases (20 out of 33 cases, 60.6%) and disease control (DC) in the 2 groups was 33 cases (33 out of 35 cases, 94.3%) and 26 cases (26 out of 33 cases, 78.8%) respectively (P=0.041, P=0.031). Alanine transaminase (ALT) and Aspartate transaminase (AST) significantly increased in the DEB-TACE and c-TACE groups 1 week later (P<0.001). There were no serious complications in the 2 groups; incidences of nausea and vomiting were significantly lower, but instances of fever were markedly elevated in the DEB-TACE group (P=0.023, P=0.016, respectively). CONCLUSIONS The safety, feasibility, and short-term efficacy of DEB-TACE and c-TACE in the treatment of gastric cancer liver metastasis are clear. DEB-TACE leads to less incidences of nausea and vomiting but more incidences of fever than c-TACE.
本研究旨在评估载药微球经动脉化疗栓塞术（DEB-TACE）与常规经动脉化疗栓塞术（c-TACE）治疗胃腺癌肝转移特殊解剖部位的相对安全性和短期疗效。
经影像学和病理学证实的 68 例胃腺癌肝转移患者中，35 例行 DEB-TACE 治疗，33 例行 c-TACE 治疗。DEB-TACE 组 26 例男性，9 例女性，年龄 28-75 岁（56.8±6.3），c-TACE 组 19 例男性，14 例女性，年龄 33-77 岁（60.2±9.4）。比较两组患者 TACE 前后肝功能，TACE 后 1 周、1 个月比较两组患者肝肾功能。TACE 后 1、3、6 个月行 CT 和 MRI 复查，根据实体瘤疗效评价标准（mRECIST）评价近期疗效。
DEB-TACE 和 c-TACE 治疗后 1 个月，OR 分别为 29 例（35 例中 29 例，82.9%）和 20 例（33 例中 20 例，60.6%），DC 分别为 33 例（35 例中 33 例，94.3%）和 26 例（33 例中 26 例，78.8%），两组比较差异有统计学意义（P=0.041，P=0.031）。两组患者 TACE 后 1 周 ALT、AST 均显著升高（P<0.001）。两组均无严重并发症，DEB-TACE 组恶心呕吐发生率明显降低，发热发生率明显升高（P=0.023，P=0.016）。
DEB-TACE 和 c-TACE 治疗胃腺癌肝转移的安全性、可行性和短期疗效确切，DEB-TACE 较 c-TACE 恶心呕吐发生率低，发热发生率高。
