Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Division of Hematology/Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Drug Des Devel Ther. 2020 Nov 17;14:5029-5041. doi: 10.2147/DDDT.S266470. eCollection 2020.
To evaluate the therapeutic efficacy and safety of supplement transarterial chemoembolization (TACE) with drug-eluting beads TACE (DEB-TACE) through extrahepatic collateral (EHC) arteries for the treatment of hepatocellular carcinoma (HCC).
In this retrospective study, 61 unresectable HCC patients with treatment-naïve EHC blood supplies who received TACE from January 2016 to March 2019 were enrolled; of these patients, 42 (68.9%) received DEB-TACE, and 19 (31.1%) received cTACE. The hepatic tumor feeding arteries were treated in the same TACE session if it presented. The tumor response, time-to-progression (TTP), and overall survival (OS) were analyzed. Safety was assessed based on the occurrence of liver function deterioration and major complications within three months after TACE.
DEB-TACE showed better efficacy than cTACE in the disease control rate (=0.001), overall response rate (=0.005), the TTP (eight months vsthree months, =0.002) and the OS (23.8 months vs nine months, =0.045). Nine patients in the DEB-TACE group and one patient in the cTACE group were downstaged to resection or liver transplantation (21.4% vs 5.3%, =0.151). DEB-TACE and cTACE have no difference in the acute and chronic liver toxicity. With regard to complications, there was no significant difference in the occurrence of both major (16.7% vs 21.1%, =0.72) and minor (57.1% vs 47.4%, =0.48) complications between DEB-TACE and cTACE.
DEB-TACE through EHC arteries has a potential therapeutic effect in the treatment of unresectable HCC, with comparable safety compared with cTACE.
评估经肝外侧支循环（EHC）动脉补充载药微球 TACE（DEB-TACE）治疗肝细胞癌（HCC）的疗效和安全性。
本回顾性研究纳入了 2016 年 1 月至 2019 年 3 月期间接受 TACE 治疗且初次 EHC 供血的 61 例不可切除 HCC 患者；其中，42 例（68.9%）接受 DEB-TACE，19 例（31.1%）接受 cTACE。若存在，同一 TACE 治疗中会同时处理肝肿瘤供血动脉。分析肿瘤反应、无进展时间（TTP）和总生存期（OS）。安全性评估基于 TACE 后 3 个月内肝功能恶化和主要并发症的发生情况。
DEB-TACE 在疾病控制率（=0.001）、总有效率（=0.005）、TTP（8 个月比 3 个月，=0.002）和 OS（23.8 个月比 9 个月，=0.045）方面优于 cTACE。DEB-TACE 组有 9 例患者和 cTACE 组有 1 例患者降期可接受手术切除或肝移植（21.4%比 5.3%，=0.151）。DEB-TACE 和 cTACE 在急性和慢性肝毒性方面无差异。关于并发症，DEB-TACE 和 cTACE 组主要（16.7%比 21.1%，=0.72）和次要（57.1%比 47.4%，=0.48）并发症的发生率无显著差异。
DEB-TACE 经 EHC 动脉治疗不可切除 HCC 具有潜在疗效，与 cTACE 相比具有相当的安全性。
