Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, 50-1, Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
Cardiovasc Intervent Radiol. 2024 Sep;47(9):1210-1221. doi: 10.1007/s00270-024-03726-9. Epub 2024 May 14.
To compare the treatment outcomes of glass and resin microspheres for the treatment of hepatocellular carcinoma (HCC) and evaluate the prognostic factors that influence the outcomes.
We retrospectively reviewed 251 consecutive patients who underwent radioembolization for the treatment of HCC at a single tertiary center. Imaging responses after radioembolization were evaluated using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) 1.1. Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazard models were used to identify the prognostic factors.
A total of 195 patients were included in this study (glass microsphere, n = 75; resin microsphere, n = 120). The complete and objective response rates were 16.0% and 50.7% in the glass microsphere group and 17.5% and 58.3% in the resin microsphere group, respectively. Median PFS was 241 days in the glass microsphere group and 268 days in the resin microsphere group (p = 0.871). Median OS was 29 months in the glass microsphere group and 40 months in the resin microsphere group (p = 0.669). The only significant prognostic factor was bilobar tumor distribution, which favored resin microspheres (p = 0.023). Procedure-related adverse events occurred more frequently in the resin microsphere group (glass, 2.7% vs. resin, 5.0%; p < 0.001).
Glass and resin microspheres for the treatment of HCC did not show a significant difference in survival, though major adverse events occurred more frequently with the use of resin microspheres.
比较玻璃微球和树脂微球治疗肝细胞癌（HCC）的疗效，并评估影响疗效的预后因素。
我们回顾性分析了在一家三级中心接受放射性栓塞治疗 HCC 的 251 例连续患者。采用改良实体瘤反应评估标准（mRECIST）1.1 评估栓塞后影像学反应。采用 Kaplan-Meier 法分析无进展生存期（PFS）和总生存期（OS）。采用单因素和多因素 Cox 比例风险模型确定预后因素。
本研究共纳入 195 例患者（玻璃微球组 75 例，树脂微球组 120 例）。玻璃微球组完全缓解率和客观缓解率分别为 16.0%和 50.7%，树脂微球组分别为 17.5%和 58.3%。玻璃微球组中位 PFS 为 241 天，树脂微球组为 268 天（p=0.871）。玻璃微球组中位 OS 为 29 个月，树脂微球组为 40 个月（p=0.669）。唯一显著的预后因素是肿瘤分布于两叶，树脂微球组更有利（p=0.023）。树脂微球组的与操作相关的不良事件更常见（玻璃微球组 2.7% vs. 树脂微球组 5.0%；p<0.001）。
玻璃微球和树脂微球治疗 HCC 的生存结果无显著差异，但树脂微球组更易发生严重不良事件。
