Zhang Weihua, Wu Linxia, Chen Lei, Ren Yanqiao, Sun Tao, Sun Bo, Zhu Licheng, Liu Yiming, Zheng Chuansheng
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Oncol. 2022 May 17;12:828850. doi: 10.3389/fonc.2022.828850. eCollection 2022.
Patients with different primary tumor oligometastases can obtain survival benefits from external radiotherapy. The study was conducted to explore the efficacy and safety of transarterial chemoembolization (TACE) plus iodine 125 seed (TACE-I) implantation for hepatocellular carcinoma (HCC) oligometastases.
187 patients who received TACE-I in our institution were retrospectively reviewed from January 2014 to December 2018. Thirty-two patients were included in the analysis. The primary endpoints of the study were overall survival (OS) and progression-free survival (PFS). The secondary endpoints of the study were tumor response and PFS of the metastatic sites.
The median OS (mOS) of patients was 18 months, and the median PFS (mPFS) was 7 months. The objective response rate (ORR) and disease control rate (DCR) of patients three months after receiving TACE-I were 34.4% and 71.9%, respectively. The ORR and DCR of patients for metastatic sites were 50% and 81.3%, respectively. The mPFS of patients for metastatic sites was 14 months. The univariable and multivariable regression analyses indicated that the ECOG score was an independent predictor for mOS and mPFS. The number of iodine seeds and ECOG scores were independent predictors for mPFS for metastatic sites. After patients received TACE-I, the most common adverse events were abdominal pain, fever, and appetite. The adverse events of patients were relieved after receiving symptomatic treatments.
Iodine 125 seed implantation may be an effective and safe treatment for patients with hepatocellular carcinoma with oligometastasis, thereby providing a new selective option for these patients.
不同原发性肿瘤寡转移患者可从外照射放疗中获得生存益处。本研究旨在探讨经动脉化疗栓塞术（TACE）联合碘125粒子（TACE-I）植入治疗肝细胞癌（HCC）寡转移的疗效和安全性。
回顾性分析2014年1月至2018年12月在我院接受TACE-I治疗的187例患者。纳入分析32例患者。本研究的主要终点为总生存期（OS）和无进展生存期（PFS）。次要终点为肿瘤反应和转移部位的PFS。
患者的中位OS（mOS）为18个月，中位PFS（mPFS）为7个月。接受TACE-I治疗3个月后患者的客观缓解率（ORR）和疾病控制率（DCR）分别为34.4%和71.9%。转移部位患者的ORR和DCR分别为50%和81.3%。转移部位患者的mPFS为l4个月。单因素和多因素回归分析表明，美国东部肿瘤协作组（ECOG）评分是mOS和mPFS的独立预测因素。碘粒子数量和ECOG评分是转移部位mPFS的独立预测因素。患者接受TACE-I治疗后，最常见的不良事件为腹痛、发热和食欲减退。经对症治疗后患者的不良事件得到缓解。
碘125粒子植入术可能是治疗肝细胞癌寡转移患者的一种有效且安全的治疗方法，从而为这些患者提供了一种新的选择。
