Sato Rui, Moriguchi Michihisa, Saiga Atsushi, Asahara Kazuhisa, Aramaki Takeshi
Division of Interventional Radiology, Shizuoka Cancer Center, Shizuoka, Japan.
Molecular Gastroenterology and Hepatology, Graduate School of Medical Science Kyoto Prefectural University of Medicine, Kyoto, Japan.
Cancer Med. 2024 Jul;13(14):e7446. doi: 10.1002/cam4.7446.
The Japanese Interventional oncology group (JIVROSG) showed the efficacy and safety of nonselective transarterial chemoembolization (TACE) with fine cisplatin powder (diamminedichloroplatinum; DDP-H) (65 mg/m) and porous gelatin particles (DDP-H TACE) without lipiodol for extensive multifocal hepatocellular carcinoma (HCC). However, there are no studies on this method following the JIVROSG study. Therefore, we aimed to evaluate the efficacy of this new DDP-H TACE and its effect on liver function.
We retrospectively reviewed the medical records of TACE-naïve patients with multifocal HCC (Child-Pugh class A, up-to-seven out, no prior history of systemic therapy) who underwent whole-liver DDP-H TACE between January 2006 and December 2019.
Sixty patients were included in this study. The median age of the patients was 71 (range, 35-88) years. The median maximum size of tumors was 26 (range, 8-184) mm; 86.7% of patients met the up-to-11 criteria out. The overall survival duration was 30.3 months. At the time of initial evaluation (median, 45 days), the overall response rate was 65.0%; the disease control rate was 86.7% based on the modified response evaluation criteria in solid tumors guideline. Although nine patients' liver function had deteriorated to Child-Pugh class B at initial evaluation, six of them recovered to Child-Pugh class A. Only three patients (5%) showed permanently impaired liver function.
Whole-liver DDP-H TACE without lipiodol or beads effectively reduced tumors and preserved liver function.
日本介入肿瘤学组（JIVROSG）已证实，对于广泛的多灶性肝细胞癌（HCC），使用顺铂细粉（二氯二氨铂；DDP-H）（65mg/m）和多孔明胶颗粒进行非选择性经动脉化疗栓塞（TACE）（DDP-H TACE）且不使用碘油的方法具有疗效和安全性。然而，在JIVROSG研究之后，尚无关于该方法的研究。因此，我们旨在评估这种新型DDP-H TACE的疗效及其对肝功能的影响。
我们回顾性分析了2006年1月至2019年12月期间接受全肝DDP-H TACE的初治多灶性HCC患者（Child-Pugh A级，最多7个病灶，无全身治疗史）的病历。
本研究纳入了60例患者。患者的中位年龄为71岁（范围35-88岁）。肿瘤的中位最大直径为26mm（范围8-184mm）；86.7%的患者符合最多11个病灶的标准。总生存时间为30.3个月。在初始评估时（中位时间45天），总缓解率为65.0%；根据实体瘤改良疗效评估标准，疾病控制率为86.7%。虽然有9例患者在初始评估时肝功能恶化为Child-Pugh B级，但其中6例恢复到了Child-Pugh A级。只有3例患者（5%）出现永久性肝功能损害。
不使用碘油或微球的全肝DDP-H TACE能有效缩小肿瘤并保留肝功能。
