ALBI评分是肝细胞癌经选择性内放射治疗（SIRT）后毒性反应的有力预测指标。
ALBI Score Is a Strong Predictor of Toxicity Following SIRT for Hepatocellular Carcinoma.
作者信息
Lescure Céline, Estrade Florian, Pedrono Maud, Campillo-Gimenez Boris, Le Sourd Samuel, Pracht Marc, Palard Xavier, Bourien Héloïse, Muzellec Léa, Uguen Thomas, Rolland Yan, Garin Etienne, Edeline Julien
机构信息
Centre Eugène Marquis, Medical Oncology, 35043 Rennes, France.
Centre Eugène Marquis, Clinical Research, 35043 Rennes, France.
出版信息
Cancers (Basel). 2021 Jul 28;13(15):3794. doi: 10.3390/cancers13153794.
BACKGROUND
Selective internal radiation therapy (SIRT) is an innovative treatment of hepatocellular carcinoma (HCC). The albumin-bilirubin (ALBI) score was designed to better evaluate liver functions in HCC.
METHODS
We studied, retrospectively, data from patients treated with SIRT for HCC. The primary endpoint was the occurrence of radioembolization-induced liver disease (REILD). The secondary endpoint was overall survival (OS).
RESULTS
222 patients were studied. The ALBI grade 1 patients had significantly less REILD (3.4%) after the first SIRT than ALBI grade 2 or 3 patients (16.8%, = 0.002). Of the 207 patients with data, 77 (37.2%) had a worsening of ALBI grade after one SIRT. The baseline ALBI grade was significantly associated with OS ( = 0.001), also in the multivariable analysis. The ALBI grade after the first SIRT was significantly associated with OS ( ≤ 0.001), with median OS of 26.4 months (CI 95% 18.2-34.7) for ALBI grade 1 patients ( = 48) versus 17.3 months (CI 95% 12.9-21.8) for ALBI grade 2 patients ( = 123) and 8.1 months (CI 95% 4.1-12.1) for ALBI grade 3 patients ( = 36).
CONCLUSIONS
The baseline ALBI grade is a strong predictor of REILD. The baseline ALBI score and variations of ALBI are prognostic after SIRT.
背景
选择性内放射治疗（SIRT）是肝细胞癌（HCC）的一种创新治疗方法。白蛋白-胆红素（ALBI）评分旨在更好地评估HCC患者的肝功能。
方法
我们回顾性研究了接受SIRT治疗HCC患者的数据。主要终点是放射性栓塞诱导的肝病（REILD）的发生情况。次要终点是总生存期（OS）。
结果
共研究了222例患者。首次SIRT治疗后，ALBI 1级患者发生REILD的比例（3.4%）显著低于ALBI 2级或3级患者（16.8%，P = 0.002）。在207例有数据的患者中，77例（37.2%）在一次SIRT治疗后ALBI分级恶化。基线ALBI分级与OS显著相关（P = 0.001），多变量分析中也是如此。首次SIRT治疗后的ALBI分级与OS显著相关（P≤0.001），ALBI 1级患者（n = 48）的中位OS为26.4个月（95%CI 18.2 - 34.7），ALBI 2级患者（n = 123）为17.3个月（95%CI 12.9 - 21.8），ALBI 3级患者（n = 36）为8.1个月（95%CI 4.1 - 12.1）。
结论
基线ALBI分级是REILD的有力预测指标。基线ALBI评分及ALBI变化在SIRT治疗后具有预后价值。
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