经聚乙二醇载药微球栓塞化疗治疗肝细胞癌：580 例患者生存的荟萃多中心分析。

Transarterial Chemoembolization with Anthracyclines-Loaded Polyethylene Glycol Drug Eluting Microspheres for the Treatment of Hepatocellular Carcinoma: A Pooled Multicentric Analysis of Survival in 580 Patients.

机构信息

Interventional Radiology Unit, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.

NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.

出版信息

Cardiovasc Intervent Radiol. 2023 Apr;46(4):436-446. doi: 10.1007/s00270-023-03362-9. Epub 2023 Feb 10.

PURPOSE

To evaluate survival, efficacy and safety of transarterial chemoembolization (TACE) in the treatment of patients with hepatocellular carcinoma (HCC), through a pooled analysis of patients with BCLC 0, A and B HCC stages, treated with polyethylene glycol drug eluting microspheres (PEG-DEM) TACE.

MATERIALS AND METHODS

Patients from 3 retrospective and 2 prospective registries were included. Overall survival (OS), progression-free survival (PFS), tumour response and safety were evaluated. Multivariate Cox regression analysis was performed to evaluate predictors of OS.

RESULTS

A total of 580 patients (72.1% males, mean age 66.9 ± 10.3 years) were included. 43.5% had BCLC A, and 41.0% BCLC B disease stage, and 85.8% were Child-Pugh class A. Complete and partial response (mRECIST or RECIST1.1) were achieved in 60.14% and 27.11% of patients, with overall response and disease control rates of 87.30% and 94.60%, respectively. Median OS was 50.8 months for the total population, and 61.2 and 38.1 months for BCLC 0 + A and BCLC B patients, respectively. Median PFS for the total population, BCLC 0 + A and BCLC B groups was 15.6, 21.6 and 12.7 months, respectively.

CONCLUSIONS

This multicentric pooled analysis confirmed efficacy and safety of PEG-DEM TACE, with a median OS of 50.8 months.

目的

通过对接受聚乙二醇载药微球（PEG-DEM）经动脉化疗栓塞（TACE）治疗的 BCLC 0、A 和 B 期 HCC 患者的汇总分析，评估 TACE 治疗肝细胞癌（HCC）患者的生存率、疗效和安全性。

材料与方法

纳入了 3 项回顾性和 2 项前瞻性注册研究的患者。评估了总生存期（OS）、无进展生存期（PFS）、肿瘤反应和安全性。采用多变量 Cox 回归分析评估 OS 的预测因素。

结果

共纳入 580 例患者（72.1%为男性，平均年龄 66.9±10.3 岁）。43.5%的患者为 BCLC A 期，41.0%为 BCLC B 期，85.8%的患者为 Child-Pugh 分级 A 级。60.14%和 27.11%的患者达到完全和部分缓解（mRECIST 或 RECIST1.1），总体缓解率和疾病控制率分别为 87.30%和 94.60%。总人群的中位 OS 为 50.8 个月，BCLC 0+A 期和 BCLC B 期患者的中位 OS 分别为 61.2 和 38.1 个月。总人群、BCLC 0+A 期和 BCLC B 期患者的中位 PFS 分别为 15.6、21.6 和 12.7 个月。