Department of Radiology, Xiangya Hospital Central South University, Changsha, China.
Department of Radiology, Wuhan General Hospita of Guangzhou Military, 627 Wuluo Road, Wuhan 430070, China.
Clin Res Hepatol Gastroenterol. 2021 Mar;45(2):101460. doi: 10.1016/j.clinre.2020.05.008. Epub 2020 Jun 24.
Transarterial chemoembolization (TACE) is widely applied in hepatocellular carcinoma (HCC) patients who are not suitable for surgical treatment. We aimed to investigate the treatment outcomes and comprehensive prognostic factors of CalliSpheres® microspheres (CSM) drug-eluting bead TACE (DEB-TACE) treatment and conventional TACE (cTACE) treatment in HCC patients.
Three hundred and thirty-five HCC patients received DEB-TACE or cTACE treatment were consecutively enrolled in multi-center, retrospective cohort study. Treatment response was conducted at M1, M3 or M6 after treatment. Progression free survival (PFS) and overall survival (OS) were recorded. Thirty-seven baseline factors including demographic characteristics, clinical features, biochemical indexes and previous treatment histories were selected.
In total patients, history of drink and largest nodule size≥7cm independently predicted worse ORR, DEB-TACE predicted better OS, while largest nodule size≥7cm, increased Child-Pugh stage, ALB abnormal, ALP abnormal or AFP abnormal predicted worse survival. For DEB-TACE group, previous cTACE and ANC abnormal independently predicted worse ORR, and hepatic vein invasion, increased Child-Pugh stage or AFP abnormal independently predicted poor survival. For cTACE group, largest nodule size≥7cm independently predicted poor ORR, and multifocal disease as well as ALB abnormal predicted poor OS.
History of drink, largest nodule size≥7cm, DEB-TACE, increased Child-Pugh stage, abnormal ALB, ALP or AFP are potential prognostic factors in total patients, previous cTACE and ANC abnormal, hepatic vein invasion, increased Child-Pugh stage or AFP abnormal are potential prognostic factors in DEB-TA group, and largest nodule size≥7cm, multifocal disease and ALB abnormal are potential prognostic factors in cTACE group.
经动脉化疗栓塞术（TACE）广泛应用于不适合手术治疗的肝细胞癌（HCC）患者。我们旨在研究 CalliSpheres®微球（CSM）载药微球栓塞化疗（DEB-TACE）与传统 TACE（cTACE）治疗 HCC 患者的治疗效果和综合预后因素。
本多中心回顾性队列研究连续纳入 335 例 HCC 患者，分别接受 DEB-TACE 或 cTACE 治疗。治疗后 1、3 或 6 个月进行治疗反应评估。记录无进展生存期（PFS）和总生存期（OS）。选择 37 项基线因素，包括人口统计学特征、临床特征、生化指标和既往治疗史。
在所有患者中，饮酒史和最大结节直径≥7cm 独立预测较差的客观缓解率（ORR），DEB-TACE 预测较好的 OS，而最大结节直径≥7cm、增加的 Child-Pugh 分级、白蛋白异常、碱性磷酸酶异常或甲胎蛋白异常预测较差的生存。对于 DEB-TACE 组，既往 cTACE 和 ANC 异常独立预测较差的 ORR，而肝静脉侵犯、增加的 Child-Pugh 分级或 AFP 异常独立预测较差的生存。对于 cTACE 组，最大结节直径≥7cm 独立预测较差的 ORR，多灶性病变和白蛋白异常预测较差的 OS。
饮酒史、最大结节直径≥7cm、DEB-TACE、增加的 Child-Pugh 分级、白蛋白异常、碱性磷酸酶异常或 AFP 异常是所有患者的潜在预后因素，既往 cTACE 和 ANC 异常、肝静脉侵犯、增加的 Child-Pugh 分级或 AFP 异常是 DEB-TACE 组的潜在预后因素，而最大结节直径≥7cm、多灶性病变和白蛋白异常是 cTACE 组的潜在预后因素。
