Chen Meng, Xu Rongde, Chen Xiaoming, Mai Qicong
Department of Interventional, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510030, China.
Transl Cancer Res. 2020 Mar;9(3):1361-1370. doi: 10.21037/tcr.2020.01.15.
Hepatocellular carcinoma (HCC) is most common malignancies around world. Transcatheter arterial chemoembolization (TACE) is recognized as the first-line treatment for HCC by NCCN, and its efficacy is widely reported. However, repeated TACE induces hepatic fibrosis. How to reduce hepatic fibrosis and retard cirrhosis is an urgent problem in treatment of HCC. To verify the efficacy of doxorubicin-eluting HepaSphere for TACE in the treatment of unresectable HCC.
We retrospectively analyzed 91 patients with unresectable HCC underwent TACE from June 2015 to June 2018. Among which, 51 cases were treated with HepaSphere-and 40 cases were treated with iodized oil. The primary endpoint was got according to the Modified Response Evaluation Criteria in Solid Tumors (mRECIST). Type IV collagen (IV-C), layer mucin (LN), amino-terminal propeptide of type III procollagen (PIIINP), and hyaluronic acid (HA) were tested before and after TACE treatment.
Serologic factors of the groups were re-examined 3 days after TACE, which showed higher ALT and AST in the conventional TACE group than in the HepaSphere-TACE group (P<0.05). The postoperative efficacies were evaluated according to the mRECIST criteria. No difference in the short-term efficacy between these two groups (P>0.05) were found. Moreover, serologic factors for fibrosis were further re-examined 6 months later, showing no differences for IV-C and PIIINP (P=0.906 and 0.574, respectively). However, LN and HA were slightly higher in C-TACE group than HepaSphere-TACE group (P=0.045 and 0.048, respectively).
HepaSphere-TACE is prevents the occurrence of late hepatic fibrosis effectively.
肝细胞癌（HCC）是全球最常见的恶性肿瘤。经动脉化疗栓塞术（TACE）被美国国立综合癌症网络（NCCN）认定为HCC的一线治疗方法，其疗效已得到广泛报道。然而，重复进行TACE会导致肝纤维化。如何减少肝纤维化并延缓肝硬化是HCC治疗中的一个紧迫问题。为验证载多柔比星的HepaSphere微球用于TACE治疗不可切除HCC的疗效。
我们回顾性分析了2015年6月至2018年6月期间接受TACE治疗的91例不可切除HCC患者。其中，51例采用HepaSphere微球治疗，40例采用碘化油治疗。主要终点依据实体瘤改良疗效评价标准（mRECIST）得出。在TACE治疗前后检测IV型胶原（IV-C）、层黏连蛋白（LN）、III型前胶原氨基端前肽（PIIINP）和透明质酸（HA）。
TACE治疗3天后对两组的血清学指标进行复查，结果显示传统TACE组的ALT和AST水平高于HepaSphere微球-TACE组（P<0.05）。根据mRECIST标准评估术后疗效。发现两组之间的短期疗效无差异（P>0.05）。此外，6个月后对纤维化的血清学指标进一步复查，结果显示IV-C和PIIINP无差异（分别为P=0.906和0.574）。然而，C-TACE组的LN和HA略高于HepaSphere微球-TACE组（分别为P=0.045和0.048）。
HepaSphere微球-TACE可有效预防晚期肝纤维化的发生。
