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经动脉化疗栓塞联合放射性碘治疗原发性肝癌的短期疗效评估

Short-term efficacy assessment of transarterial chemoembolization combined with radioactive iodine therapy in primary hepatocellular carcinoma.

作者信息

Wang Lei, Huang Kun, Zhang Yu, Wu Yi-Fan, Yue Zhen-Dong, Fan Zhen-Hua, Liu Fu-Quan, Li Yong-Wu, Dong Jian

机构信息

Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.

Department of Radiology, Chinese Medical University Affiliated First Hospital, Shenyang 110001, Liaoning Province, China.

出版信息

World J Gastrointest Surg. 2023 Jan 27;15(1):105-113. doi: 10.4240/wjgs.v15.i1.105.

Abstract

BACKGROUND

Transarterial chemoembolization (TACE) is an effective treatment for primary hepatocellular carcinoma (PHC). Radioactive iodine therapy has been used in the treatment of advanced PHC, especially in patients with portal vein tumor thrombosis. However, data on the therapeutic effect of TACE combined with radioactive iodine therapy in PHC are scarce.

AIM

To investigate the clinical efficacy of TACE combined with radioactive iodine implantation therapy in advanced PHC perfusion computed tomography (CT).

METHODS

For this study, 98 advanced PHC patients were recruited and divided randomly into the study and control groups. Patients in the study group were treated with TACE combined radioactive iodine implantation therapy. Patients in the control group were treated with only TACE. The tumor lesion length, clinical effect, serum alpha-fetoprotein (AFP) and CT perfusion parameters were compared before and after therapy, and statistical analysis was performed.

RESULTS

There was no significant difference in tumor length and serum AFP between the study and control groups ( > 0.05) before treatment. However, the tumor length and serum AFP in the study group were lower than those in the control group 1 mo and 3 mo after therapy. After 3 mo of treatment, the complete and partial remission rate of the study group was 93.88%, which was significantly higher than the control group (77.55%) ( < 0.05). Before treatment, there were no significant differences between the two groups on the perfusion CT variables, including the lesion blood volume, permeability surface, blood flow, hepatic artery flow and mean transit time ( > 0.05). After 3 mo of treatment, all perfusion CT variables were lower in the study group compared to the control group ( < 0.05). The survival time of patients in the study group was 22 mo compared to 18 mo in the control group, which was significantly different [log rank (Mantel-Cox) = 4.318, = 0.038].

CONCLUSION

TACE combined with radioactive iodine implantation in the treatment of advanced PHC can inhibit the formation of blood vessels in tumor tissue and reduce the perfusion level of tumor lesions, thereby improving the clinical efficacy and prolonging the survival time of patients.

摘要

背景

经动脉化疗栓塞术(TACE)是原发性肝细胞癌(PHC)的一种有效治疗方法。放射性碘治疗已用于晚期PHC的治疗,尤其是门静脉肿瘤血栓形成的患者。然而,关于TACE联合放射性碘治疗PHC的疗效数据较少。

目的

探讨TACE联合放射性碘植入治疗晚期PHC灌注计算机断层扫描(CT)的临床疗效。

方法

本研究招募了98例晚期PHC患者,随机分为研究组和对照组。研究组患者接受TACE联合放射性碘植入治疗。对照组患者仅接受TACE治疗。比较治疗前后肿瘤病变长度、临床疗效、血清甲胎蛋白(AFP)和CT灌注参数,并进行统计学分析。

结果

治疗前,研究组和对照组的肿瘤长度和血清AFP无显著差异(P>0.05)。然而,治疗后1个月和3个月,研究组的肿瘤长度和血清AFP低于对照组。治疗3个月后,研究组的完全缓解率和部分缓解率为93.88%,显著高于对照组(77.55%)(P<0.05)。治疗前,两组在灌注CT变量上无显著差异,包括病变血容量、渗透表面积、血流、肝动脉血流和平均通过时间(P>0.05)。治疗3个月后,研究组的所有灌注CT变量均低于对照组(P<0.05)。研究组患者的生存时间为22个月,而对照组为18个月,差异显著[对数秩(Mantel-Cox)=4.318,P=0.038]。

结论

TACE联合放射性碘植入治疗晚期PHC可抑制肿瘤组织血管形成,降低肿瘤病变的灌注水平,从而提高临床疗效,延长患者生存时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a568/9896495/26625d2f0536/WJGS-15-105-g001.jpg

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