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选择性肝静脉闭塞联合动脉化疗栓塞术与传统经动脉化疗栓塞术治疗肝细胞癌的疗效与安全性分析

Efficacy and safety analysis of selective hepatic vein occlusion combined with arterial chemoembolization versus conventional transarterial chemoembolization in the treatment of hepatocellular carcinoma.

作者信息

Chang Jiang, Wang Haochen, Li Jian, Jin Long

机构信息

Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

出版信息

J Gastrointest Oncol. 2024 Apr 30;15(2):710-720. doi: 10.21037/jgo-23-992. Epub 2024 Apr 18.

Abstract

BACKGROUND

Transarterial chemoembolization (TACE) is a non-radical treatment. How to improve the local response rate of tumor is the direction we have been exploring. The purpose of this study is to compare the efficacy and safety of occlusion-TACE (O-TACE) versus conventional TACE (C-TACE) in the treatment of patients with early to mid-stage hepatocellular carcinoma (HCC) of lesions being confined to the same hepatic venous drainage area.

METHODS

In this study, 40 patients with HCC were prospectively enrolled and randomly assigned to the O-TACE and C-TACE groups, and the efficacy of all patients was assessed at 1, 2, and 3 months after the first treatment, and adverse events (AEs) occurring during the treatment period were also recorded.

RESULTS

At 1, 2 and 3 months after the first treatment, patients in the O-TACE group had significantly better complete response (CR) rates (35% . 5%, P=0.04; 50% . 15%, P=0.04; 70% . 30%, P=0.02) than those in the C-TACE group. The most common AE was abdominal pain, and the liver function indexes of patients in both groups returned to the baseline level at 1 month after the first treatment, and there was no statistically significant difference in the rate of AEs between the two groups.

CONCLUSIONS

O-TACE has a better CR rate and a favorable safety profile in patients with early to mid-stage HCC of lesions being confined to the same hepatic venous drainage area.

摘要

背景

经动脉化疗栓塞术(TACE)是一种非根治性治疗方法。如何提高肿瘤局部缓解率是我们一直探索的方向。本研究旨在比较闭塞性TACE(O-TACE)与传统TACE(C-TACE)治疗病变局限于同一肝静脉引流区的早中期肝细胞癌(HCC)患者的疗效和安全性。

方法

本研究前瞻性纳入40例HCC患者,随机分为O-TACE组和C-TACE组,在首次治疗后1、2和3个月评估所有患者的疗效,并记录治疗期间发生的不良事件(AE)。

结果

首次治疗后1、2和3个月,O-TACE组患者的完全缓解(CR)率显著高于C-TACE组(分别为35%对5%,P=0.04;50%对15%,P=0.04;70%对30%,P=0.02)。最常见的AE是腹痛,两组患者的肝功能指标在首次治疗后1个月均恢复至基线水平,两组AE发生率差异无统计学意义。

结论

对于病变局限于同一肝静脉引流区的早中期HCC患者,O-TACE具有更好的CR率和良好的安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5270/11094505/99306df286f4/jgo-15-02-710-f1.jpg

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