经动脉放射性栓塞治疗肝细胞癌的疗效、安全性及预后预测因素：一项回顾性研究
The efficacy, safety, and predictors of outcomes of transarterial radioembolization for hepatocellular carcinoma: a retrospective study.
作者信息
Abdallah Mohamed A, Wongjarupong Nicha, Hassan Mohamed A, Taha Wesam, Abdalla Abubaker, Bampoh Sally, Onyirioha Kristeen, Nelson Morgan, Glubranson Lyn A, Wiseman Gregory A, Fleming Chad J, Andrews James C, Mahipal Amit, Roberts Lewis R
机构信息
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science , Rochester, MN, USA.
Department of Internal Medicine, University of South Dakota Sanford School of Medicine , Sioux Falls, SD, USA.
出版信息
Expert Rev Gastroenterol Hepatol. 2020 Jul;14(7):619-629. doi: 10.1080/17474124.2020.1777856. Epub 2020 Jun 22.
OBJECTIVES
Yttrium-90 transarterial radioembolization (TARE) is a safe, effective modality of locoregional therapy for intermediate and advanced-stage hepatocellular carcinoma (HCC). We aim to identify novel predictors of important outcomes of TARE therapy.
METHODS
A single-center retrospective study of 166 patients treated with TARE for HCC at Mayo Clinic Rochester between 2005-2015 and followed until December 2017. Multivariate logistic and stepwise regression analysis models were used to identify variables associated with overall survival (OS) and progression-free survival (PFS).
RESULTS
The median OS and the median PFS were12.9 (95% CI: 11.0-17.3), and 8 months (95% CI: 6-11), respectively. Macrovascular invasion (HR: 1.9 [1.3-2.8]), Child-Pugh score (CPS) B or C vs. A (HR: 1.8 [1.2-2.7]), Eastern Cooperative Oncology Group Performance status (ECOG-PS) 2 or 1 vs. 0 (HR: 1.6 [1.1-2.4]) and activity (A) of administered radiation dose (HR: 1.005[1.00-1.010), independently correlated with poorer OS. Infiltrative HCC (HR: 2.4 [1.3-4.5), macrovascular invasion (HR: 1.6 [1.1-2.7]), and high activity of administered radiation dose (HR: 1.005 [1.00-1.010) were associated with worse PFS.
CONCLUSION
In HCC patients treated with TARE; macrovascular invasion, the activity of radiation dose, CPS, ECOG-PS, and infiltrative HCC predict OS and PFS.
目的
钇-90 经动脉放射性栓塞术（TARE）是一种用于中晚期肝细胞癌（HCC）的安全、有效的局部治疗方式。我们旨在确定 TARE 治疗重要结局的新预测指标。
方法
对 2005 年至 2015 年在罗切斯特梅奥诊所接受 TARE 治疗 HCC 的 166 例患者进行单中心回顾性研究，并随访至 2017 年 12 月。采用多因素逻辑回归和逐步回归分析模型来确定与总生存期（OS）和无进展生存期（PFS）相关变量。
结果
中位 OS 和中位 PFS 分别为 12.9 个月（95%CI：11.0 - 17.3）和 8 个月（95%CI：6 - 11）。大血管侵犯（HR：1.9 [1.3 - 2.8]）、Child-Pugh 评分（CPS）B 或 C 与 A 相比（HR：1.8 [1.2 - 2.7]）、东部肿瘤协作组体能状态（ECOG-PS）2 或 1 与 0 相比（HR：1.6 [1.1 - 2.4]）以及给予的放射剂量活性（A）（HR：1.005[1.00 - 1.010]），均与较差的 OS 独立相关。浸润性 HCC（HR：2.4 [1.3 - 4.5]）、大血管侵犯（HR：1.6 [1.1 - 2.7]）以及给予的放射剂量高活性（HR：1.005 [1.00 - 1.010]）与较差的 PFS 相关。
结论
在接受 TARE 治疗的 HCC 患者中，大血管侵犯、放射剂量活性、CPS、ECOG-PS 和浸润性 HCC 可预测 OS 和 PFS。
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