Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
Ann Palliat Med. 2023 May;12(3):448-457. doi: 10.21037/apm-22-1048. Epub 2023 Feb 9.
Transarterial chemoembolization (TACE) is the standard treatment for Barcelona Clinic Liver Cancer (BCLC)-B hepatocellular carcinoma (HCC). A novel glass membrane emulsification device (GMD) produces a high percentage of water/oil emulsions with homogeneous and stable droplets. There are few reports on the efficacy of GMD-conventional-TACE (GMD-c-TACE); therefore, we aimed to evaluate the effectiveness of GMD-c-TACE.
Seventy-one patients with HCC with tumor diameter <5 cm who underwent c-TACE with and without GMD were included in this study to investigate local recurrence and hepatic functional reserve.
The local recurrence rates of TACE without GMD were 3.0% at 6 months, 16.7% at 12 months, and 35.0% at 18 months, around where it plateaued. In contrast, the local recurrence rates in the GMD-c-TACE group were 0.0% at 12 months and 15.4% at 18 months, respectively. Thus, GMD-c-TAE had a significantly lower local recurrence. ALBI score of c-TACE with GMD significantly preserved hepatic reserve. Multivariate analysis showed that GMD-c-TACE could suppress local recurrence and maintain hepatic reserve.
GMD-c-TACE allows dense lipiodol accumulation in the tumor and the attainment of good local control. Additionally, in vitro evaluation of the sustained release properties of GMD, the inhibition of the release of anticancer drugs may lead to maintain hepatic reserve. GMD-c-TACE is useful in preventing local recurrence and is expected to become the standard treatment form of c-TACE in the future.
经动脉化疗栓塞术(TACE)是巴塞罗那临床肝癌(BCLC)-B 期肝细胞癌(HCC)的标准治疗方法。一种新型玻璃膜乳化装置(GMD)可产生高比例的水/油乳剂,具有均匀且稳定的液滴。关于 GMD-常规-TACE(GMD-c-TACE)的疗效报告较少,因此,我们旨在评估 GMD-c-TACE 的有效性。
本研究纳入了 71 例肿瘤直径<5cm 的 HCC 患者,这些患者接受了 GMD 辅助的 c-TACE 和未使用 GMD 的 c-TACE,以研究局部复发和肝功能储备情况。
未使用 GMD 的 TACE 的局部复发率在 6 个月时为 3.0%,在 12 个月时为 16.7%,在 18 个月时为 35.0%,基本达到平台期。相比之下,GMD-c-TACE 组的局部复发率在 12 个月和 18 个月时分别为 0.0%和 15.4%。因此,GMD-c-TACE 具有明显更低的局部复发率。GMD-c-TACE 的 ALBI 评分显著保留了肝储备。多变量分析显示,GMD-c-TACE 可抑制局部复发并维持肝储备。
GMD-c-TACE 可使肿瘤内的碘油积聚更密集,实现良好的局部控制。此外,通过体外评价 GMD 的持续释放特性,抑制抗癌药物的释放可能会导致肝储备的维持。GMD-c-TACE 有助于预防局部复发,有望成为未来 c-TACE 的标准治疗形式。