乙醇浸泡明胶海绵与微球用于肝细胞癌肝动脉门静脉瘘栓塞的比较

Comparison of ethanol-soaked gelatin sponge and microspheres for hepatic arterioportal fistulas embolization in hepatic cellular carcinoma.

作者信息

Yuan Guang-Sheng, Zhang Li-Li, Chen Zi-Tong, Zhang Cun-Jing, Tian Shu-Hui, Gong Ming-Xia, Wang Peng, Guo Lei, Shao Nan, Liu Bin

机构信息

Institute of Interventional Oncology, Shandong University, Jinan 250033, Shandong Province, China; Department of Radiology, Dongying Traditional Chinese Medicine Hospital, Dongying 257055, Shandong Province, China.

Department of Gastroenterology, People's Hospital of Qihe County, Dezhou 251100, Shandong Province, China.

出版信息

World J Gastrointest Oncol. 2023 Sep 15;15(9):1595-1604. doi: 10.4251/wjgo.v15.i9.1595.

DOI:10.4251/wjgo.v15.i9.1595

PMID:37746643

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10514721/

Abstract

BACKGROUND

Hepatic arterioportal fistulas (APFs) are common in hepatocellular carcinoma (HCC). Moreover, correlated with poor prognosis, APFs often complicate anti-tumor treatments, including transarterial chemoembolization (TACE).

AIM

To compare the efficacy of ethanol-soaked gelatin sponges (ESG) and microspheres in the management of APFs and their impact on the prognosis of HCC.

METHODS

Data from patients diagnosed with HCC or hepatic APFs between June 2016 and December 2019 were retrospectively analyzed. Furthermore, APFs were embolized with ESG (group E) or microspheres (group M) during TACE. The primary outcomes were disease control rate (DCR) and objective response rate (ORR). The secondary outcomes included immediate and first follow-up APF improvement, overall survival (OS), and progression-free survival (PFS).

RESULTS

Altogether, 91 participants were enrolled in the study, comprising 46 in group E and 45 in group M. The DCR was 93.5% and 91.1% in groups E and M, respectively ( = 0.714). The ORRs were 91.3% and 66.7% in groups E and M, respectively ( = 0.004). The APFs improved immediately after the procedure in 43 (93.5%) patients in group E and 40 (88.9%) patients in group M ( = 0.485). After 2 mo, APF improvement was achieved in 37 (80.4%) and 33 (73.3%) participants in groups E and M, respectively ( = 0.421). The OS was 26.2 ± 1.4 and 20.6 ± 1.1 mo in groups E and M, respectively ( = 0.004), whereas the PFS was 16.6 ± 1.0 and 13.8 ± 0.7 mo in groups E and M, respectively ( = 0.012).

CONCLUSION

Compared with microspheres, ESG embolization demonstrated a higher ORR and longer OS and PFS in patients of HCC with hepatic APFs.

摘要

背景

肝动脉门静脉瘘（APF）在肝细胞癌（HCC）中很常见。此外，APF与预后不良相关，常使包括经动脉化疗栓塞术（TACE）在内的抗肿瘤治疗复杂化。

目的

比较乙醇浸泡明胶海绵（ESG）和微球在治疗APF中的疗效及其对HCC预后的影响。

方法

回顾性分析2016年6月至2019年12月期间诊断为HCC或肝APF的患者的数据。此外，在TACE期间用ESG（E组）或微球（M组）栓塞APF。主要结局为疾病控制率（DCR）和客观缓解率（ORR）。次要结局包括即刻和首次随访时APF的改善情况、总生存期（OS）和无进展生存期（PFS）。

结果

共91名参与者纳入研究，E组46名，M组45名。E组和M组的DCR分别为93.5%和91.1%（ = 0.714）。E组和M组的ORR分别为91.3%和66.7%（ = 0.004）。E组43例（93.5%）患者和M组40例（88.9%）患者术后APF即刻改善（ = 0.485）。2个月后，E组和M组分别有37例（80.4%）和33例（73.3%）参与者的APF得到改善（ = 0.421）。E组和M组的OS分别为26.2±1.4个月和20.6±1.1个月（ = 0.004），而E组和M组的PFS分别为16.6±1.0个月和13.8±0.7个月（ = 0.012）。