Y90 放射性栓塞治疗对中晚期肝细胞癌是否有效，以及白蛋白 - 胆红素评分对生存的预测因素是什么？

Is the Y90-radioembolization treatment effective on the intermediate-advanced stage of hepatocellular carcinoma and what is the albumin-bilirubin score's prediction factor for survival?

作者信息

Evirgen Sami, Cavus Bilger, Gokturk Suut, Iliaz Raim, Ozkan Zeynep Gozde, Baran Bulent, Ormeci Asli Ciftcibası, Soyer Ozlem Mutluay, Karaca Cetin, Demir Kadir, Besisik Selman Fatih, Poyanli Arzu, Akyuz Filiz, Kaymakoglu Sabahattin

机构信息

Department of Gastroenterology, Istanbul University School of Medicine, Istanbul, Turkiye.

Department of Nuclear Medicine, Istanbul University School of Medicine, Istanbul, Turkiye.

出版信息

Hepatol Forum. 2023 Jun 16;4(3):103-107. doi: 10.14744/hf.2022.2022.0036. eCollection 2023.

DOI:10.14744/hf.2022.2022.0036

PMID:37822305

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10564249/

Abstract

BACKGROUND AND AIM

Radioembolization (RE) is a one of the palliative treatments that have been used to down stage and/or increase the survival time in intermediate-advanced stages of HCC. We aimed to evaluate the clinical impact of RE and the clinical use of the albumin-bilirubin (ALBI) score as a predictor for survival in HCC patients.

MATERIALS AND METHODS

Fifty-nine unresectable hepatocellular carcinoma (HCC) patients were enrolled. RE was performed in 28 of them (group 1) and 31 patients were followed up in the natural course (NC) (group 2). Patients were classified according to the Child-Pugh score (only cirrhotic patients), Barcelona clinic liver cancer (BCLC) staging, and ALBI scores were also calculated.

RESULTS

All patients in Group 1 were cirrhotic and their BCLC stages were as follows: 60.7% stage B and 39.3% stage C. In Group 2, 83.9% of patients were cirrhotic and their BCLC stages were as follows: 9.7% stage B, 51.6% stage C, and 38.7% stage D. Mortality rates were 82% and 100% in Groups 1 and 2, respectively. The median overall survival (OS) was 13.5 months (95% CI: 10.4-16.6 months) and 4.5 months (95% CI: 3.5-5.5 months) in Groups 1 and 2, respectively (p=0.000). When RE was applied to patients with ALBI Grade 1 and 2, the median OS was statistically higher than in the NC group, respectively (p<0.001, p<0.001).

CONCLUSION

RE is an effective treatment method at the advanced stages of HCC. The ALBI score is a more useful and practical than the other prognostic tools.

摘要

背景与目的

放射性栓塞（RE）是一种姑息治疗方法，已用于降低中晚期肝癌的分期和/或延长其生存时间。我们旨在评估RE的临床影响以及白蛋白-胆红素（ALBI）评分作为肝癌患者生存预测指标的临床应用价值。

材料与方法

纳入59例不可切除的肝细胞癌（HCC）患者。其中28例接受了RE治疗（第1组），31例患者接受自然病程观察（NC）（第2组）。根据Child-Pugh评分（仅适用于肝硬化患者）、巴塞罗那临床肝癌（BCLC）分期对患者进行分类，并计算ALBI评分。

结果

第1组所有患者均为肝硬化患者，其BCLC分期如下：60.7%为B期，39.3%为C期。第2组中，83.9%的患者为肝硬化患者，其BCLC分期如下：9.7%为B期，51.6%为C期，38.7%为D期。第1组和第2组的死亡率分别为82%和100%。第1组和第2组的中位总生存期（OS）分别为13.5个月（95%CI：10.4 - 16.6个月）和4.5个月（95%CI：3.5 - 5.5个月）（p = 0.000）。当对ALBI 1级和2级患者应用RE时，其OS中位数在统计学上分别高于NC组（p < 0.001，p < 0.001）。