与传统化疗栓塞相比，钇-90放射性栓塞在肝细胞癌患者中具有更好的临床结局：一项倾向评分匹配研究。
Yttrium-90 Radioembolization Is Associated with Better Clinical Outcomes in Patients with Hepatocellular Carcinoma Compared with Conventional Chemoembolization: A Propensity Score-Matched Study.
作者信息
Kim Minseok Albert, Jang Heejoon, Choi Na Ryung, Nam Joon Yeul, Lee Yun Bin, Cho Eun Ju, Lee Jeong-Hoon, Yu Su Jong, Kim Hyo-Cheol, Chung Jin Wook, Yoon Jung-Hwan, Kim Yoon Jun
机构信息
Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
出版信息
J Hepatocell Carcinoma. 2021 Dec 7;8:1565-1577. doi: 10.2147/JHC.S335879. eCollection 2021.
BACKGROUND
Both trans-arterial radioembolization (TARE) and conventional trans-arterial chemoembolization (TACE) can effectively control hepatocellular carcinoma (HCC) in patients who are not suitable for curative resection. This study compared the effectiveness of TARE and conventional TACE as the initial trans-arterial treatment for hepatocellular carcinoma (HCC) assessed by tumor response and clinical outcomes.
MATERIAL AND METHODS
Data were retrospectively analyzed the propensity score-matched cohort for overall survival (OS), progression-free survival (PFS), and intrahepatic PFS in patients who have received TARE or TACE as the first HCC treatment from March 2012 to December 2017.
RESULTS
A total of 138 patients initially treated with TARE (n = 54) or TACE (n = 84) was included in this study. Of 138 patients, median age was 59 years and the mean follow-up period was 27.6 months. TARE showed better OS (hazard ratio [HR] = 0.54, 95% confidence interval [CI] = 0.31-0.92, log-rank = 0.02), better PFS (HR = 0.51, 95% CI = 0.36-0.97, log-rank = 0.04), and better intrahepatic PFS (HR = 0.51, 95% CI = 0.30-0.88, log-rank = 0.01) compared with TACE. TARE was an independent prognostic factor for OS (adjusted HR [aHR] = 0.52, 95% CI = 0.30-0.90, = 0.02), PFS (aHR = 0.57, 95% CI = 0.35-0.94, = 0.03), and intrahepatic PFS (aHR = 0.49, 95% CI = 0.28-0.84, = 0.01).
CONCLUSION
TARE as initial trans-arterial treatment is associated with better clinical outcomes such as longer OS compared with TACE in patients with HCC.
背景
经动脉放射性栓塞术（TARE）和传统经动脉化疗栓塞术（TACE）均可有效控制不适宜进行根治性切除的肝细胞癌（HCC）患者的病情。本研究比较了TARE和传统TACE作为肝细胞癌（HCC）初始经动脉治疗手段的有效性，评估指标为肿瘤反应和临床结局。
材料与方法
回顾性分析2012年3月至2017年12月期间接受TARE或TACE作为首次HCC治疗的患者的倾向评分匹配队列的总生存期（OS）、无进展生存期（PFS）和肝内PFS。
结果
本研究共纳入138例最初接受TARE（n = 54）或TACE（n = 84）治疗的患者。138例患者的中位年龄为59岁，平均随访期为27.6个月。与TACE相比，TARE的总生存期更佳（风险比[HR]=0.54，95%置信区间[CI]=0.31 - 0.92，对数秩检验P=0.02）、无进展生存期更佳（HR = 0.51，95% CI = 0.36 - 0.97，对数秩检验P = 0.04）以及肝内无进展生存期更佳（HR = 0.51，95% CI = 0.30 - 0.88，对数秩检验P = 0.01）。TARE是总生存期（校正后HR[aHR]=0.52，95% CI = 0.30 - 0.90，P = 0.02）、无进展生存期（aHR = 0.57，95% CI = 0.35 - 0.94，P = 0.03）和肝内无进展生存期（aHR = 0.49，95% CI = 0.28 - 0.84，P = 0.01）的独立预后因素。
结论
在HCC患者中，与TACE相比，TARE作为初始经动脉治疗与更好的临床结局相关，如更长的总生存期。
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