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载雷替曲塞的载药微球经肝动脉化疗栓塞治疗不可切除或复发性肝细胞癌的临床疗效。

Clinical Outcomes of Drug-Eluting Bead Transarterial Chemoembolization Loaded with Raltitrexed for the Treatment of Unresectable or Recurrent Hepatocellular Carcinoma.

机构信息

Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Can J Gastroenterol Hepatol. 2022 Aug 23;2022:2602121. doi: 10.1155/2022/2602121. eCollection 2022.

Abstract

OBJECTIVES

Although raltitrexed shows therapeutic effects in many types of malignant tumors, the therapeutic effects and safety of drug-eluting bead transarterial chemoembolization (DEB-TACE) loaded with raltitrexed for the treatment of hepatocellular carcinoma (HCC) are rare. This study aimed to investigate the safety and efficacy of DEB-TACE with raltitrexed-loaded CalliSpheres beads (CB) in patients with unresectable or recurrent HCC.

METHODS

Between May 2018 and October 2021, 41 patients with unresectable or recurrent HCC treated by DEB-TACE loaded with raltitrexed were retrospectively enrolled. The primary end points were overall survival and progression-free survival. The response evaluation criteria in solid tumors (RECIST) criteria and modified RECIST criteria (mRECIST) were used to assess the tumor response after the DEB-TACE procedure.

RESULTS

A total of 79 DEB-TACE procedures were successfully performed, and the technical success rate was 100%. The overall response rate and disease control rate assessed by mRECIST criteria were 76.9% and 88.5%, 62.5% and 70.8%, and 35.3% and 47.1%, respectively, at 1, 3, and 6 months postprocedure. The mean progression-free survival and overall survival were 21.6 ± 3.6 and 43.7 ± 5.8 months, respectively. The 6-, 24-, and 36-month overall survival rates were 86.8%, 62.7%, and 57.1%, respectively. Minor complications were observed in 21 patients (51.2%), with no treatment-related mortality or severe adverse events. The most common treatment-related complications were abdominal pain (48.8%) and nausea (29.3%).

CONCLUSION

DEB-TACE with raltitrexed-loaded CB suggests a feasible, safe, and efficacious palliative regimen in unresectable or recurrent HCC patients.

摘要

目的

尽管雷替曲塞在多种恶性肿瘤中显示出治疗效果,但载雷替曲塞的载药微球栓塞化疗(DEB-TACE)治疗肝细胞癌(HCC)的疗效和安全性鲜有报道。本研究旨在探讨载雷替曲塞的 CalliSpheres 载药微球(CB)DEB-TACE 治疗不可切除或复发性 HCC 的安全性和有效性。

方法

回顾性纳入 2018 年 5 月至 2021 年 10 月期间采用载雷替曲塞 DEB-TACE 治疗的 41 例不可切除或复发性 HCC 患者。主要终点为总生存期和无进展生存期。采用实体瘤疗效评价标准(RECIST)和改良 RECIST(mRECIST)标准评估 DEB-TACE 术后肿瘤反应。

结果

共成功进行了 79 次 DEB-TACE 治疗,技术成功率为 100%。mRECIST 标准评估的总缓解率和疾病控制率分别为 76.9%和 88.5%、62.5%和 70.8%、35.3%和 47.1%,分别在术后 1、3 和 6 个月时。平均无进展生存期和总生存期分别为 21.6±3.6 个月和 43.7±5.8 个月。6、24 和 36 个月的总生存率分别为 86.8%、62.7%和 57.1%。21 例(51.2%)患者出现轻微并发症,无治疗相关死亡或严重不良事件。最常见的治疗相关并发症为腹痛(48.8%)和恶心(29.3%)。

结论

载雷替曲塞的 CB-DEB-TACE 为不可切除或复发性 HCC 患者提供了一种可行、安全且有效的姑息治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a76/9427303/1210fe25d0c1/CJGH2022-2602121.001.jpg

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