DEB-TACE 治疗局部进展期肝细胞癌的临床疗效：5 年真实世界经验。
Clinical outcomes of DEB-TACE in locally advanced hepatocellular carcinoma: A 5-year real world experience.
机构信息
Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America.
Department of Radiology, Madigan Army Medical Center, Tacoma, Washington, United States of America.
出版信息
PLoS One. 2024 Sep 12;19(9):e0309693. doi: 10.1371/journal.pone.0309693. eCollection 2024.
PURPOSE
To evaluate outcomes including safety and efficacy of drug-eluting bead trans-arterial chemo-embolization (DEB-TACE) in the treatment of locally advanced hepatocellular carcinoma (LA-HCC).
MATERIALS AND METHODS
In this single-center, retrospective study, we evaluated 471 consecutive patients with LA-HCC who underwent DEB-TACE from 2015 to 2020. Efficacy of DEB-TACE was assessed based on the imaging response using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) and the biochemical response using alpha-fetoprotein (AFP) levels at 1-month follow-up. Adverse events, progression free survival (PFS), and overall survival were also examined.
RESULTS
HCC distribution was bilobar in 49% with largest lesion mean size of 4.3 cm ± 3.2, and a majority of patients (46.7%) were Barcelona Club Liver Cancer (BCLC) stage B. Complete radiologic response was achieved in 120 (25.5%) patients, comparable to a reported 28% rate for conventional TACE. Biochemically, 41 (8.7%) patients achieved complete response, and 113 (24%) had a partial response. A total of 59 (12.5%) patients were successfully bridged to liver transplantation. Major adverse events were observed in 3%, while 7.2% experienced post-embolization syndrome. Mean PFS was 6.7 months ± 6.6, and overall survival was 64%, 16.3%, 2.1% at 1, 3, and 5 years, respectively.
CONCLUSION
Based on our real world experience at a single center, DEB-TACE remains the locoregional therapy of choice for LA-HCC due to its favorable safety and efficacy profile.
目的
评估载药微球经导管动脉化疗栓塞术（DEB-TACE）治疗局部进展期肝细胞癌（LA-HCC）的疗效和安全性。
材料和方法
本研究回顾性分析了 2015 年至 2020 年期间在我院接受 DEB-TACE 治疗的 471 例 LA-HCC 患者的临床资料。采用改良实体瘤反应评价标准（mRECIST）评价 DEB-TACE 的疗效，采用 1 个月时 AFP 水平评价其生化疗效。观察不良事件、无进展生存期（PFS）和总生存期（OS）。
结果
HCC 分布于双侧肝叶者占 49%，最大肿瘤直径为 4.3cm±3.2cm，巴塞罗那临床肝癌分期（BCLC）B 期患者占 46.7%。120 例（25.5%）患者获得完全缓解，与常规 TACE 报道的 28%相似。生化完全缓解 41 例（8.7%），部分缓解 113 例（24%）。59 例（12.5%）患者成功桥接肝移植。3%的患者发生严重不良事件，7.2%的患者发生栓塞后综合征。中位 PFS 为 6.7 个月±6.6 个月，1、3、5 年 OS 分别为 64%、16.3%、2.1%。
结论
基于单中心的真实世界数据，DEB-TACE 治疗 LA-HCC 的疗效确切，安全性好，是局部区域治疗的首选。
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