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载药微球经动脉化疗栓塞联合碘-125粒子植入治疗非小细胞肺癌肝转移患者

CalliSpheres microsphere transarterial chemoembolization combined with I brachytherapy for patients with non-small-cell lung cancer liver metastases.

作者信息

Zhao Guangsheng, Liu Song, Liu Ying, Li Xiang, Yu Guangji, Zhang Yuewei, Bian Jie, Wu Jianlin, Zhou Jun, Gao Fei

机构信息

Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.

Cancer Interventional Center, Linyi Cancer Hospital, Linyi, China.

出版信息

Front Oncol. 2022 Aug 12;12:882061. doi: 10.3389/fonc.2022.882061. eCollection 2022.

Abstract

OBJECTIVE

Poor prognosis and limited treatments of liver metastases from non-small-cell lung cancer (NSCLC) after radical surgery are critical issues. The current study aimed to evaluate the efficacy and safety of CalliSpheres microsphere transarterial chemoembolization (CSM-TACE) plus I brachytherapy in these patients.

METHODS

A total of 23 patients with liver metastases from NSCLC after radical surgery were included. All patients received CSM-TACE 1-3 times, then I brachytherapy was carried out following the last CSM-TACE. Complete response (CR), objective response rate (ORR), disease control rate (DCR), survival, and adverse events were evaluated.

RESULTS

CR, ORR and DCR were 43.5%, 87.0%, and 100%, respectively, at three months; furthermore, they were 78.3%, 100%, and 100% accordingly at six months. Moreover, most European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30) subscales of functions (including physical and emotional function) and symptoms (including pain, nausea, and vomiting) were generally improved at three months (all < 0.05). Furthermore, median progression-free survival (PFS) was 14.0 [95% confidence interval (CI): 10.4-17.6] months, with a 1-year PFS rate of 62.9%, but the 2-year PFS rate was not reached. Moreover, the median overall survival (OS) was 22.0 (95% CI: 16.8-27.2) months, with a 1-year OS rate of 91.3% and a 2-year OS rate of 43.5%. Additionally, the main adverse events included fever (100%), pain (65.2%), liver function impairment (65.2%), fatigue (56.5%), and nausea and vomiting (52.2%), which were all categorized as grade 1-2.

CONCLUSION

CSM-TACE plus I brachytherapy is effective and safe in patients with liver metastases from NSCLC after radical surgery, providing a potentially optimal option in these patients.

摘要

目的

非小细胞肺癌(NSCLC)根治性手术后肝转移的预后较差且治疗方法有限,这是关键问题。本研究旨在评估载药微球经动脉化疗栓塞术(CSM-TACE)联合碘125粒子植入术对这些患者的疗效和安全性。

方法

纳入23例NSCLC根治性手术后发生肝转移的患者。所有患者接受1-3次CSM-TACE治疗,在最后一次CSM-TACE治疗后进行碘125粒子植入术。评估完全缓解(CR)、客观缓解率(ORR)、疾病控制率(DCR)、生存率和不良事件。

结果

三个月时CR、ORR和DCR分别为43.5%、87.0%和100%;六个月时相应为78.3%、100%和100%。此外,大多数欧洲癌症研究与治疗组织生活质量核心问卷30(QLQ-C30)功能子量表(包括身体和情感功能)和症状子量表(包括疼痛、恶心和呕吐)在三个月时总体有所改善(均P<0.05)。此外,中位无进展生存期(PFS)为14.0[95%置信区间(CI):10.4-17.6]个月,1年PFS率为62.9%,但2年PFS率未达到。中位总生存期(OS)为22.0(95%CI:16.8-27.2)个月,1年OS率为91.3%,2年OS率为43.5%。此外,主要不良事件包括发热(100%)、疼痛(65.2%)、肝功能损害(65.2%)、疲劳(56.5%)以及恶心和呕吐(52.2%),均为1-2级。

结论

CSM-TACE联合碘125粒子植入术对NSCLC根治性手术后肝转移患者有效且安全,为这些患者提供了一种潜在的最佳选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f9/9413194/4061d0ab9468/fonc-12-882061-g001.jpg

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