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经动脉放射性栓塞治疗老年肝细胞癌患者的疗效和安全性:单中心经验。

Efficacy and Safety of Transarterial Radioembolization in Elderly Patients with Hepatocellular Carcinoma: A Single-Center Experience.

机构信息

Department of Gastroenterology, Çukurova University, Adana, Turkey.

Department of Medical Education, Mersin University, Mersin, Turkey.

出版信息

Turk J Gastroenterol. 2024 Mar;35(3):204-211. doi: 10.5152/tjg.2024.23155.

Abstract

BACKGROUND/AIMS: Hepatocellular carcinoma is a major cause of mortality and morbidity in both cirrhotic and non-cirrhotic patients, and most patients are suitable for locoregional and/or systemic therapy at the time of diagnosis. In this study, we aimed to determine the efficacy and safety of transarterial radioembolization in elderly patients.

MATERIALS AND METHODS

Patients diagnosed with hepatocellular carcinoma between 2013 and 2022 were screened retrospectively. The patients were divided into 2 groups: the elderly (age >70 years) and the young (age <70 years). Transarterial radioembolization response was evaluated according to the Response Evaluation Criteria in Solid Tumors.

RESULTS

Ninety patients were included in the young group, and 56 patients were in the elderly group. It was observed that male dominance was less in the elderly group (P > .05). Hepatitis B was the most common cause in both groups. There were no significant differences between groups with regard to morphological features of tumors [tumor focality (single; 62.2% and 60.7%, respectively) and maximal tumor diameter (6.9 and 6.55 cm, respectively)], transarterial radioembolization responses (51.1% and 39.3%, respectively), survival (9 and 8.5 months), and both early and late side effects (P > .05). Age was not found to be an effective factor in transarterial radioembolization response (P > .05).

CONCLUSION

No differences in the safety and efficacy of transarterial radioembolization were observed between the groups. In addition, it was observed that age was not a predictive factor for adverse events. In elderly patients in the frail group, it should be considered that age alone should not be seen as a limitation in the transarterial radioembolization decision.

摘要

背景/目的:肝细胞癌是肝硬化和非肝硬化患者死亡和发病的主要原因,大多数患者在诊断时适合接受局部区域和/或全身治疗。本研究旨在确定经动脉放射性栓塞治疗老年患者的疗效和安全性。

材料和方法

回顾性筛选了 2013 年至 2022 年间诊断为肝细胞癌的患者。患者分为两组:老年组(年龄>70 岁)和年轻组(年龄<70 岁)。根据实体瘤反应评估标准评估经动脉放射性栓塞治疗反应。

结果

年轻组 90 例,老年组 56 例。观察到老年组男性比例较低(P>0.05)。两组乙型肝炎均为最常见病因。两组肿瘤形态特征[肿瘤灶性(单发;分别为 62.2%和 60.7%)和最大肿瘤直径(分别为 6.9 和 6.55 cm)]、经动脉放射性栓塞治疗反应(分别为 51.1%和 39.3%)、生存率(9 个月和 8.5 个月)以及早期和晚期不良反应发生率之间均无显著差异(P>0.05)。年龄不是经动脉放射性栓塞治疗反应的有效因素(P>0.05)。

结论

两组经动脉放射性栓塞治疗的安全性和疗效无差异。此外,观察到年龄不是不良事件的预测因素。对于体弱的老年患者,应考虑到年龄本身不应成为经动脉放射性栓塞治疗决策的限制因素。

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