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经动脉化疗栓塞联合碘-125粒子植入治疗多灶性肝细胞癌

Transarterial chemoembolization with I seed insertion for multifocal hepatocellular carcinoma.

作者信息

Wang You-Bin, Zhang Ying, Li Peng-Fei, Bao Le, Zhang Wen-Tao

机构信息

Department of Interventional Radiology, Xuzhou Cancer Hospital, Xuzhou, China.

Department of Radiology, Xuzhou Central Hospital, Xuzhou, China.

出版信息

Front Oncol. 2024 Apr 15;14:1384293. doi: 10.3389/fonc.2024.1384293. eCollection 2024.

Abstract

BACKGROUND

A common treatment strategy for individuals with multifocal hepatocellular carcinoma (HCC) who are not candidates for surgical resection is transarterial chemoembolization (TACE). Combining TACE with I seed insertion (ISI) may offer a means of enhancing therapeutic efficacy. The purpose of this study was to compare the therapeutic efficacy of TACE administered with and without ISI for the treatment of multifocal HCC.

METHODS

The data from the two centers were analyzed retrospectively. The present study involved 85 consecutive patients with multifocal HCC who underwent TACE between January 2018 and December 2021. Of these patients, 43 were in the combined group, receiving TACE with ISI, and 42 were in the TACE-only group, receiving TACE without ISI. Comparisons of treatment outcomes were made between these groups.

RESULTS

No significant differences in baseline data were observed between these groups of patients. Higher rates of complete (60.5% vs. 33.3%, P = 0.016) and total (93.0% vs. 61.9%, P = 0.001) responses were evident in the combined group compared to the TACE-only group. Median progression-free survival (PFS, 13 vs. 10 months, P = 0.014) and overall survival (OS, 22 vs. 17 months, P = 0.035) were also significantly longer in the combined group than in the TACE-only group. Using a Cox regression analysis, risk variables associated with shorter PFS and OS included Child-Pugh B status (P = 0.027 and 0.004) and only TACE treatment (P = 0.011 and 0.022).

CONCLUSION

In summary, these findings suggest that, as compared to TACE alone, combining TACE and ISI can enhance HCC patients' treatment outcomes and survival.

摘要

背景

对于不适合手术切除的多灶性肝细胞癌(HCC)患者,一种常见的治疗策略是经动脉化疗栓塞术(TACE)。将TACE与碘-125粒子植入(ISI)相结合可能提供一种提高治疗效果的方法。本研究的目的是比较TACE联合ISI与单纯TACE治疗多灶性HCC的疗效。

方法

对两个中心的数据进行回顾性分析。本研究纳入了2018年1月至2021年12月期间连续接受TACE治疗的85例多灶性HCC患者。其中,43例患者为联合治疗组,接受TACE联合ISI治疗;42例患者为单纯TACE组,接受单纯TACE治疗。对这两组患者的治疗结果进行比较。

结果

两组患者的基线数据无显著差异。与单纯TACE组相比,联合治疗组的完全缓解率(60.5%对33.3%,P = 0.016)和总缓解率(93.0%对61.9%,P = 0.001)更高。联合治疗组的中位无进展生存期(PFS,13个月对10个月,P = 0.014)和总生存期(OS,22个月对17个月,P = 0.035)也显著长于单纯TACE组。使用Cox回归分析,与较短PFS和OS相关的风险变量包括Child-Pugh B级状态(P = 0.027和0.004)以及单纯TACE治疗(P = 0.011和0.022)。

结论

总之,这些结果表明,与单纯TACE相比,TACE联合ISI可提高HCC患者的治疗效果和生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d49/11056516/aeb3969d42c3/fonc-14-1384293-g001.jpg

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