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I-125 粒子近距离放射治疗联合经动脉化疗栓塞术治疗包膜下肝细胞癌

I-125 seeds brachytherapy with transcatheter arterial chemoembolization for subcapsular hepatocellular carcinoma.

作者信息

Gao Fu-Lei, Wang Yong, Huang Xiang-Zhong, Pan Tian-Fan, Guo Jin-He

机构信息

Department of Interventional Radiology, Affiliated Jiangyin Hospital, Medical College of Southeast University, Jiangyin, China.

Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.

出版信息

BMC Gastroenterol. 2022 Jun 1;22(1):273. doi: 10.1186/s12876-022-02356-0.

Abstract

BACKGROUND

I-125 seeds brachytherapy (ISB) has been used to improve the clinical effectiveness of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). We aim to appraise the safety and clinical efficacy of combined ISB and TACE for the treatment of subcapsular HCC.

MATERIALS AND METHODS

A retrospective investigative study extending from January 2017 to December 2020, involved individuals suffering from subcapsular HCC, who were subjected to TACE treatment with or without ISB in our center. The clinical effectiveness was compared between 2 groups.

RESULTS

Sixty-four patients, in total, with subcapsular HCC had to undergo TACE with (n = 32) or without (n = 32) ISB in our center. After CT-guided ISB, only 2 (6.3%) patients experienced a self-limited pneumothorax. Combined treatment resulted in a significantly higher complete response (56.3% vs. 18.8%, P = 0.002) and total response (90.7% vs. 59.4%, P = 0.004) rates than that of TACE alone. In comparison to the TACE alone group, the median progression-free survival was substantially longer in the combined treatment group (11 months vs. 5 months, P = 0.016). Further, 15 and 28 patients in combined and TACE alone groups respectively died within the follow-up. The median OS was comparable between combined and TACE alone groups (22 months vs. 18 months, P = 0.529).

CONCLUSIONS

Combined TACE and ISB therapy is a safe treatment method for individuals suffering from subcapsular HCC. When compared, combined treatment had significantly enhanced clinical efficacy as a subcapsular HCC therapy, in comparison to TACE alone.

摘要

背景

碘-125粒子近距离放射治疗(ISB)已被用于提高经动脉化疗栓塞术(TACE)治疗肝细胞癌(HCC)的临床疗效。我们旨在评估ISB联合TACE治疗包膜下HCC的安全性和临床疗效。

材料与方法

一项回顾性研究,时间跨度为2017年1月至2020年12月,研究对象为患有包膜下HCC并在本中心接受TACE治疗(有或无ISB)的患者。比较两组的临床疗效。

结果

本中心共有64例包膜下HCC患者接受了TACE治疗,其中32例联合ISB,32例未联合ISB。CT引导下ISB治疗后,仅2例(6.3%)患者出现自限性气胸。联合治疗的完全缓解率(56.3%对18.8%,P = 0.002)和总缓解率(90.7%对59.4%,P = 0.004)显著高于单纯TACE治疗。与单纯TACE组相比,联合治疗组的无进展生存期显著延长(11个月对5个月,P = 0.016)。此外,联合治疗组和单纯TACE组分别有15例和28例患者在随访期间死亡。联合治疗组和单纯TACE组的中位总生存期相当(22个月对18个月,P = 0.529)。

结论

TACE联合ISB治疗是包膜下HCC患者的一种安全治疗方法。相比之下,联合治疗作为包膜下HCC的一种治疗方法,与单纯TACE相比,临床疗效显著提高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04d5/9158176/e689f3c30445/12876_2022_2356_Fig1_HTML.jpg

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