Jiang Jian-Qiang, Huang Jin-Tao, Zhong Bin-Yan, Wang Wei-Dong, Sun Jun-Hui, Wang Qi, Ding Wen-Bin, Ni Cai-Fang, Zhu Xiao-Li
Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
Department of Interventional Therapy, Nantong Tumor Hospital, Nantong, People's Republic of China.
J Hepatocell Carcinoma. 2023 Sep 26;10:1629-1638. doi: 10.2147/JHC.S422300. eCollection 2023.
This study aimed to evaluate the efficacy and safety of transarterial chemoembolization (TACE) in patients with unresectable early or intermediate hepatocellular carcinoma (HCC) and Child-Pugh (CP)-B liver dysfunction.
This multicenter retrospective study enrolled patients with treatment-naïve HCC treated with TACE monotherapy between January 2012 and December 2020 at six Chinese hospitals. The primary outcome was overall survival (OS), and the secondary outcomes included the objective response rate (ORR) according to the modified RECIST and adverse events (AEs). Propensity score matching (PSM) was performed to reduce bias between the CP-B and CP-A groups.
A total of 847 patients were included in the study. CP-A patients had significantly longer OS (median, 22.0 vs 19.3 months, = 0.032) than CP-B (score of 7-9) patients, but a non-significant trend compared with CP-B (score of 7) patients (median, 22.0 vs 20.5 months, = 0.254). After PSM, the median OS was 22.7 months for CP-A patients, while it was 19.3 months for CP-B (score of 7-9) patients (p = 0.026) and 20.5 months for CP-B (score of 7) patients (p = 0.155). CP-A patients achieved a significantly better ORR (53.0% vs 35.8%, P < 0.05) compared to CP-B (score of 7-9) patients, but a non-significant trend was observed in CP-B (score of 7) patients (53.0% vs 51.1%, P > 0.05). The post-embolization syndrome rates in the CP-A and CP-B (score of 7) cohorts were 52.1% and 53.3%, respectively. No new safety concerns were observed.
Patients with HCC with a CP score of 7 receiving TACE showed a similar prognosis and safety profile to CP-A patients.
本研究旨在评估经动脉化疗栓塞术（TACE）在无法切除的早期或中期肝细胞癌（HCC）及Child-Pugh（CP）-B级肝功能不全患者中的疗效和安全性。
这项多中心回顾性研究纳入了2012年1月至2020年12月期间在中国六家医院接受TACE单药治疗的初治HCC患者。主要结局为总生存期（OS），次要结局包括根据改良RECIST标准的客观缓解率（ORR）和不良事件（AE）。进行倾向评分匹配（PSM）以减少CP-B组和CP-A组之间的偏差。
本研究共纳入847例患者。CP-A组患者的OS明显长于CP-B（评分7 - 9分）组患者（中位数，22.0个月对19.3个月；P = 0.032），但与CP-B（评分7分）组患者相比差异无统计学意义（中位数，22.0个月对20.5个月；P = 0.254）。PSM后，CP-A组患者的中位OS为22.7个月，CP-B（评分7 - 9分）组患者为19.3个月（P = 0.026），CP-B（评分7分）组患者为20.5个月（P = 0.155）。与CP-B（评分7 - 9分）组患者相比，CP-A组患者的ORR明显更好（53.0%对35.8%，P < 0.05），但在CP-B（评分7分）组患者中差异无统计学意义（53.0%对51.1%，P > 0.05）。CP-A组和CP-B（评分7分）组的栓塞后综合征发生率分别为52.1%和53.3%。未观察到新的安全问题。
CP评分为7分的HCC患者接受TACE治疗后的预后和安全性与CP-A组患者相似。
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