Yuan Hui, Lu Hailei, Zeng Jiahuan, Zhang Yan, Shen Lujun
Department of Minimally Invasive Interventional Therapy, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou, 510060, People's Republic of China.
J Interv Med. 2021 Aug 13;4(4):184-189. doi: 10.1016/j.jimed.2021.08.004. eCollection 2021 Nov.
To analyze the radiation dose received by patients during hepatic artery infusion chemotherapy (HAIC) and transarterial chemoembolization (TACE) procedures and the related influencing factors.
Data of 162 cases in the HAIC group and 230 cases in the TACE group were collected. The included covariates were Age (<45/45-59/≥60 years), BMI levels (underweight/normal weight/obesity), focus Dye of tumor (present/absent), lesion size (<5cm/≥5cm), superselection (present/absent), hepatic vascular variation (present/absent). The endpoints were postoperative dose-area product (DAP), exposure time and Air kerma (AK).
Of all included patients, the HAIC group patients were younger than those in the TACE group (P = 0.028). The proportion of patients with large lesions in the HAIC group was higher than the TACE group (45.7% vs. 33.9%, P = 0.019). The proportion of patients who had superselection was lower in the HAIC group as compared to the TACE group (61.7% vs. 82.2%, P < 0.001). Generally, the HAIC group has lower DAP, exposure time and AK by 36.3% (P < 0.001), 38.2% (P < 0.001), and 41.3% (P < 0.001) than the TACE group, respectively. Linear regression analysis showed the procedure method (HAIC/TACE, P < 0.001), type of DSA machine (Pheno/FD20, P < 0.001), BMI levels (P < 0.001), age (P = 0.021), lesion size (<5cm/≥5 cm, P = 0.031) significantly correlated with low DAP. In the HAIC group, the type of DSA machine and BMI correlated with the radiation dose, while in the TACE group, the type of DSA machine, BMI, and lesion size correlated with the radiation dose.
Compared with TACE, HAIC enables doctors and patients to receive lower radiation doses. Obese patients in both HAIC and TACE groups increase the radiation exposure in interventional doctors and patients, but large lesions only affect the radiation dose in the TACE procedure.
分析肝动脉灌注化疗（HAIC）和经动脉化疗栓塞术（TACE）过程中患者接受的辐射剂量及其相关影响因素。
收集HAIC组162例和TACE组230例的数据。纳入的协变量包括年龄（<45/45 - 59/≥60岁）、体重指数水平（体重过轻/正常体重/肥胖）、肿瘤病灶染色（有/无）、病变大小（<5cm/≥5cm）、超选择（有/无）、肝血管变异（有/无）。观察终点为术后剂量面积乘积（DAP）、曝光时间和空气比释动能（AK）。
在所有纳入患者中，HAIC组患者比TACE组患者年轻（P = 0.028）。HAIC组大病灶患者比例高于TACE组（45.7%对33.9%，P = 0.019）。HAIC组超选择患者比例低于TACE组（61.7%对82.2%，P < 0.001）。总体而言，HAIC组的DAP、曝光时间和AK分别比TACE组低36.3%（P < 0.001）、38.2%（P < 0.001）和41.3%（P < 0.001）。线性回归分析显示，手术方法（HAIC/TACE，P < 0.001）、DSA机器类型（Pheno/FD20，P < 0.001）、体重指数水平（P < 0.001）、年龄（P = 0.021）、病变大小（<5cm/≥5cm，P = 0.031）与低DAP显著相关。在HAIC组中，DSA机器类型和体重指数与辐射剂量相关，而在TACE组中，DSA机器类型、体重指数和病变大小与辐射剂量相关。
与TACE相比，HAIC可使医生和患者接受更低的辐射剂量。HAIC组和TACE组中的肥胖患者均增加了介入医生和患者的辐射暴露，但大病灶仅影响TACE手术中的辐射剂量。
