Department of Radiodiagnosis, Zagazig University School of Human Medicine, Zagazig, Egypt.
Department of Surgery, Zagazig University School of Human Medicine, Zagazig, Egypt.
Eur Radiol Exp. 2021 Mar 2;5(1):10. doi: 10.1186/s41747-021-00204-6.
No chemotherapeutic agents have been standardised for transarterial chemoembolisation (TACE). In particular, doxorubicin has no defined optimal dosage in TACE procedures. We compared low versus currently used dose of doxorubicin for TACE in patients with hepatocellular carcinoma (HCC) in terms of severity of post-embolisation syndrome (PES) and overall survival (OS).
From October 2014 to March 2018, we enrolled patients with primary HCC scheduled for TACE. Patients were randomised to receive 50 mg (group A) or 100 mg (group B) of doxorubicin. Outcomes were the rate of patients with PES; free-time-to-PES; changes in laboratory results; tumour response at 1, 3, and 6 months after TACE; and overall survival.
Twenty-eight patients (24 males, 4 females) were enrolled, aged 58.9 ± 6.8 years (mean ± standard deviation). Fifteen of them palliated with 50 mg (group A) and 13 with 100 mg (group B) of doxorubicin for a total of 68 TACE procedures (of 28 patients who had repeated TACE procedures). Visual analogue scale (VAS) and duration of pain were significantly differently lower in group A than in group B (p < 0.001). The median duration of fever was shorter in group A than in group B (p = 0.003). No significant differences between both groups were observed for tumour response to TACE and OS. The doxorubicin dose was significantly correlated with duration of pain, fever, and VAS score.
A lower dose of doxorubicin (50 mg) was associated with fewer PES symptoms compared with 100 mg, without effects on tumour response nor OS.
经动脉化疗栓塞术（TACE）尚未标准化使用化疗药物。特别是阿霉素在 TACE 中的剂量尚未确定。我们比较了原发性肝细胞癌（HCC）患者 TACE 中低剂量与目前使用剂量的阿霉素在栓塞后综合征（PES）严重程度和总生存期（OS）方面的差异。
从 2014 年 10 月至 2018 年 3 月，我们招募了计划接受 TACE 的原发性 HCC 患者。患者被随机分配接受 50mg（A 组）或 100mg（B 组）阿霉素。结果为 PES 患者的比率；无 PES 时间；实验室结果变化；TACE 后 1、3 和 6 个月的肿瘤反应；以及总生存期。
共纳入 28 例患者（24 例男性，4 例女性），年龄 58.9±6.8 岁（均值±标准差）。其中 15 例患者姑息性使用 50mg（A 组），13 例患者姑息性使用 100mg（B 组），共进行了 68 次 TACE 治疗（28 例患者重复 TACE 治疗）。A 组的视觉模拟评分（VAS）和疼痛持续时间明显低于 B 组（p<0.001）。A 组发热持续时间中位数短于 B 组（p=0.003）。两组患者 TACE 肿瘤反应和 OS 无显著差异。阿霉素剂量与疼痛持续时间、发热和 VAS 评分显著相关。
与 100mg 相比，低剂量阿霉素（50mg）与较少的 PES 症状相关，而对肿瘤反应和 OS 无影响。
