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经动脉栓塞(TAE)联合多电极消融治疗与经动脉化疗栓塞(TACE)治疗大肝细胞癌的可行性、疗效和安全性的综合干预

A comprehensive intervention on feasibility, efficacy, and safety between TAE combined with multi-applicator ablation therapy and TACE in the treatment of large hepatocellular carcinoma.

作者信息

Mahara Gehendra, Chen Guiqun, Ge Qi, Lin Zhuochen, Huang Jinhua, Zhang Jinxin

机构信息

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.

Department Minimally Invasive International Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China.

出版信息

Transl Cancer Res. 2020 Oct;9(10):6303-6312. doi: 10.21037/tcr-20-293.

Abstract

BACKGROUND

Hepatocellular carcinoma (HCC) is one of the most common tumors in recent days with high mortality and low early diagnosis rate, resulting in the fourth leading cause of deaths globally. This study aimed to evaluate the feasibility, efficacy, and safety between transcatheter arterial embolization (TAE) therapy followed by multi-applicator ablation and transarterial chemoembolization (TACE) for the treatment of large HCC.

METHODS

An intervention study conducted at the Cancer Center of Sun Yat-sen University, Guangzhou, China, with whom had large HCC. A comparison between the two groups (intervention and control group) was evaluated at different time dimensions by repeated-measures analysis of variance, Mann-Whitney U rank-sum test, where Kaplan-Meier and log-rank test calculated for the overall survival (OS), tumor response (TR), and progression-free survival (PFS).

RESULTS

This study found the improved survival rate (SR) and PFS after 1-year treatment in the observation group (Group-I) by 56.4% and 12.8%, compared to 38.3% and 8.5% in the control group (Group-II). Likewise, 1- and 2-year OS rates (OSRs) in Group-I were 66.7% and 51.4%, wherein Group-II were 48.9% and 30.0%, respectively. The short-term efficacy of Group-I, such as complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD) were 28.21%, 56.41%, 0, 15.38%, while in Group-II was 2.13%, 68.79%, 6.38% 22.70% respectively, which were significant. The short-term efficacy was more excellent in the Group-I than Group-II. The quality of life (QOL) was better in Group-I than that of Group-II.

CONCLUSIONS

TAE combined with multi-applicator ablation therapy is safer, effective with prolonged survival, and less severe adverse reactions compared to TACE therapy for the treatment of large HCC.

摘要

背景

肝细胞癌(HCC)是近年来最常见的肿瘤之一,死亡率高且早期诊断率低,是全球第四大死因。本研究旨在评估经导管动脉栓塞(TAE)治疗后多电极消融与经动脉化疗栓塞(TACE)治疗大肝癌的可行性、疗效和安全性。

方法

在中国广州中山大学肿瘤中心进行的一项干预研究,研究对象为患有大肝癌的患者。通过重复测量方差分析、曼-惠特尼U秩和检验在不同时间维度对两组(干预组和对照组)进行评估,其中采用Kaplan-Meier法和对数秩检验计算总生存期(OS)、肿瘤反应(TR)和无进展生存期(PFS)。

结果

本研究发现,观察组(第一组)在1年治疗后的生存率(SR)和无进展生存期有所提高,分别为56.4%和12.8%,而对照组(第二组)为38.3%和8.5%。同样,第一组的1年和2年总生存率(OSR)分别为66.7%和51.4%,第二组分别为48.9%和30.0%。第一组的短期疗效,如完全缓解(CR)、部分缓解(PR)、疾病稳定(SD)、疾病进展(PD)分别为28.21%、56.41%、0、15.38%,而第二组分别为2.13%、68.79%、6.38%、22.70%,差异有统计学意义。第一组的短期疗效优于第二组。第一组的生活质量(QOL)优于第二组。

结论

与TACE治疗大肝癌相比,TAE联合多电极消融治疗更安全、有效,生存期延长,不良反应较轻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88cd/8797297/d59d783129ed/tcr-09-10-6303-f1.jpg

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