Hung Matthew L, Jiang Jerry, Trieu Harry, Hao Frank, Eghbalieh Navid, Ding Peng-Xu, Lee Edward Wolfgang
Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Dumont-UCLA Transplant Center, Pfleger Liver Institute, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA.
Life (Basel). 2021 Jun 23;11(7):600. doi: 10.3390/life11070600.
The purpose of this study is to describe a single institution's experience using Oncozene (OZ) microspheres for transarterial chemoembolization (OZ-TACE) of hepatocellular carcinoma (HCC), and to compare tolerability, safety, short-term radiographic tumor response, progression-free survival (PFS), and overall survival (OS) of these procedures to TACE (LC-TACE) performed with LC beads (LC). A retrospective, matched cohort study of patients undergoing DEB-TACE (drug-eluting bead transarterial chemoembolization) with OZ or LC was performed. The cohort comprised 23 patients undergoing 29 TACE with 75 or 100 μm OZ and 24 patients undergoing 29 TACE with 100-300 μm LC. Outcome measures were changes in liver function tests, complications, treatment tolerability, short-term radiographic tumor response according to modified RECIST criteria for HCC, PFS, and 1-year OS. The Mann-Whitney U test, Fisher exact test, and log rank test were used to compare the groups. The BCLC or Child-Pugh scores were similar between the OZ and LC group. However, the two groups differed with respect to the etiology of background cirrhosis ( = 0.02). All other initial demographic and tumor characteristics were similar between the two groups. OZ-TACE used less doxorubicin per treatment compared to LC-TACE (median 50 vs. 75 mg; = 0.0005). Rates of pain, nausea, and postembolization syndrome were similar, irrespective of the embolic agent used. OZ-TACE resulted in an overall complication rate comparable to LC-TACE (20.7% vs. 10.3%; = 0.47). LC-TACE resulted in a higher percent increase in total bilirubin on post-procedure day 1 (median 18.8 vs. 0%; = 0.05), but this difference resolved at 1 month. Both OZ-TACE and LC-TACE resulted in similar complete (31% vs. 24%) and objective (66% vs. 79%) target lesion response rates on 1-month post-TACE imaging. Both OZ-TACE and LC-TACE had similar median progression-free survival (283 vs. 209 days; = 0.14) and 1-year overall survival rates (85% vs. 76%; = 0.30). With a significantly reduced dose of doxorubicin, TACE performed with Oncozene microspheres in a heterogeneous patient population is well-tolerated, safe, and produces a similar radiological response and survival rate when compared to LC Bead TACE.
本研究旨在描述一家机构使用Oncozene（OZ）微球进行肝细胞癌（HCC）经动脉化疗栓塞（OZ-TACE）的经验，并比较这些操作与使用LC微球（LC）进行的经动脉化疗栓塞（TACE，即LC-TACE）在耐受性、安全性、短期影像学肿瘤反应、无进展生存期（PFS）和总生存期（OS）方面的差异。对接受OZ或LC药物洗脱微球经动脉化疗栓塞（DEB-TACE）的患者进行了一项回顾性匹配队列研究。该队列包括23例接受29次使用75或100μm OZ微球的TACE患者，以及24例接受29次使用100 - 300μm LC微球的TACE患者。观察指标包括肝功能检查的变化、并发症、治疗耐受性、根据改良的HCC RECIST标准评估的短期影像学肿瘤反应、PFS和1年OS。采用Mann-Whitney U检验、Fisher精确检验和对数秩检验对两组进行比较。OZ组和LC组的BCLC或Child-Pugh评分相似。然而，两组在背景肝硬化的病因方面存在差异（P = 0.02）。两组之间所有其他初始人口统计学和肿瘤特征相似。与LC-TACE相比，OZ-TACE每次治疗使用的阿霉素剂量更少（中位数分别为50mg和75mg；P = 0.0005）。无论使用何种栓塞剂，疼痛、恶心和栓塞后综合征的发生率相似。OZ-TACE的总体并发症发生率与LC-TACE相当（20.7%对10.3%；P = 0.47）。LC-TACE在术后第1天总胆红素的百分比升高更高（中位数分别为18.8%和0%；P = 0.05），但这种差异在1个月时消失。OZ-TACE和LC-TACE在TACE术后1个月的影像学检查中，完全（31%对24%）和客观（66%对79%）靶病变反应率相似。OZ-TACE和LC-TACE的无进展生存期中位数相似（分别为283天和209天；P = 0.14），1年总生存率也相似（分别为85%和76%；P = 0.30）。在异质性患者群体中，使用Oncozene微球进行的TACE在阿霉素剂量显著降低的情况下，耐受性良好、安全，与LC微球TACE相比，产生的放射学反应和生存率相似。
