Zhou Tan-Yang, Zhou Guan-Hui, Zhang Yue-Lin, Nie Chun-Hui, Zhu Tong-Yin, Wang Hong-Liang, Chen Sheng-Qun, Wang Bao-Quan, Yu Zi-Niu, Wu Li-Ming, Zheng Shu-Sen, Sun Jun-Hui
Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
Zhejiang Provincial Research Center for Diagnosis and Treatment of Hepatobiliary Diseases, Hangzhou 310003, Zhejiang Province, China.
J Cancer. 2020 May 18;11(15):4534-4541. doi: 10.7150/jca.39410. eCollection 2020.
: This study aimed to evaluate the efficacy and safety of doxorubicin-loaded drug-eluting beads transarterial chemoembolization (DEB-TACE) with CalliSpheres microspheres (CSM) in treating unresectable intrahepatic cholangiocarcinoma (ICC). : 88 unresectable ICC patients who received DEB-TACE treatment with CSM were retrospectively enrolled in this study. Information about treatment response, survival and adverse events were collected. The Kaplan-Meier curve was used to evaluate progression-free survival (PFS) and overall survival (OS), and factors affecting OS were determined by Cox's proportional hazards regression model. : Tumor response of the whole sample of 88 patients was partial response (PR) in 58 (65.9%) patients, stable disease (SD) in 19 (21.6%) and progressive disease (PD) in 11 (12.5%) at one month after therapy, with no complete responses (CR). The median PFS and OS were 3.0 months and 9.0 months respectively. Cox's proportional hazards regression analysis disclosed that subsequent treatment was an independent favorable prognostic factor, while cholangiectasis, extensive intrahepatic tumor burden and extrahepatic metastasis were the three prognostic factors associated with poor survival in ICC patients. Besides, common adverse events included nausea/vomiting, abdominal pain and transient elevation of liver transaminase in patients treated by DEB-TACE with CSM. : DEB-TACE with CSM is safe and well-tolerated for unresectable ICC patients, with a low complication rate and a relative benefit in terms of survival. Subsequent treatments including systemic/loco-regional treatments is an independent favorable prognostic factor, but cholangiectasis, extensive intrahepatic tumor burden and extrahepatic metastases are the three prognostic factors associated with poor survival.
本研究旨在评估载有多柔比星的CalliSpheres微球(CSM)经动脉化疗栓塞术(DEB-TACE)治疗不可切除肝内胆管癌(ICC)的疗效和安全性。本研究回顾性纳入了88例接受CSM-DEB-TACE治疗的不可切除ICC患者。收集了治疗反应、生存情况及不良事件的信息。采用Kaplan-Meier曲线评估无进展生存期(PFS)和总生存期(OS),并通过Cox比例风险回归模型确定影响OS的因素。88例患者整个样本的肿瘤反应在治疗后1个月时,58例(65.9%)为部分缓解(PR),19例(21.6%)为疾病稳定(SD),11例(12.5%)为疾病进展(PD),无完全缓解(CR)。PFS和OS的中位数分别为3.0个月和9.0个月。Cox比例风险回归分析显示,后续治疗是一个独立的有利预后因素,而胆管扩张、广泛的肝内肿瘤负荷和肝外转移是与ICC患者生存不良相关的三个预后因素。此外,CSM-DEB-TACE治疗的患者常见不良事件包括恶心/呕吐、腹痛和肝转氨酶短暂升高。CSM-DEB-TACE对于不可切除的ICC患者是安全且耐受性良好的,并发症发生率低且在生存方面有相对获益。包括全身/局部区域治疗在内的后续治疗是一个独立的有利预后因素,但胆管扩张、广泛的肝内肿瘤负荷和肝外转移是与生存不良相关的三个预后因素。