经动脉单纯栓塞与经动脉化疗栓塞治疗中期肝细胞癌的疗效比较：一项对1008例患者的倾向评分匹配研究

Comparison of the Effectiveness of Transarterial Bland Embolization and Transarterial Chemoembolization for Intermediate-Stage Hepatocellular Carcinoma: A Propensity Score-Matched Study of 1,008 Patients.

作者信息

Zhang Hongmin, Xu Jian, Meng Haoyu, Shen Lujun

机构信息

Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People's Republic of China.

Department of Minimally Invasive Interventional Therapy, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China; State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou, People's Republic of China.

出版信息

J Vasc Interv Radiol. 2025 Jan;36(1):41-49. doi: 10.1016/j.jvir.2024.09.005. Epub 2024 Sep 17.

DOI:10.1016/j.jvir.2024.09.005

PMID:39299651

Abstract

PURPOSE

To assess the effectiveness of transarterial bland embolization (TAE) compared with transarterial chemoembolization (TACE) therapy in the treatment of patients with intermediate-stage hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

Two thousand two hundred ninety-seven patients with intermediate-stage HCC were screened, and 1,461 patients who underwent TAE or TACE as the first-choice treatment were retrospectively analyzed and baseline matched according to the 2 treatment methods. Subgroup analysis was performed among patients according to the Up-to-7 criteria. The primary endpoint was overall survival (OS).

RESULTS

A total of 1,461 patients with HCC who underwent TAE or TACE were included; 730 patients underwent TACE and 731 underwent TAE. The patients in the TAE group exhibited poorer liver function and a significantly higher rate of hepatitis B infection (P < .001) compared with the TACE group. After propensity score matching, 504 well-matched pairs of patients with intermediate-stage HCC were selected for analysis. Univariate analysis showed that TACE significantly prolonged patient survival compared with TAE (P < .001). The 1-, 2-, and 3-year OS rates were 74.3%, 57.1%, and 44.4% and for the TACE group and 58.3%, 32.4%, and 21.7% for the TAE group, respectively. Multivariate analysis showed a hazard ratio of 0.517 (95% CI, 0.442-0.605; P < .001) for the TACE approach over the TAE approach for OS. The TACE group had a significantly higher overall response rate than the TAE group (35% vs 26%; P = .024).

CONCLUSIONS

TACE resulted in higher response rate and longer OS compared with TAE as the initial treatment for intermediate-stage HCC.

摘要

目的

评估经动脉单纯栓塞术（TAE）与经动脉化疗栓塞术（TACE）治疗中期肝细胞癌（HCC）患者的疗效。

材料与方法

筛选出2297例中期HCC患者，对1461例接受TAE或TACE作为首选治疗的患者进行回顾性分析，并根据两种治疗方法进行基线匹配。根据Up-to-7标准对患者进行亚组分析。主要终点为总生存期（OS）。

结果

共纳入1461例接受TAE或TACE治疗的HCC患者；730例接受TACE治疗，731例接受TAE治疗。与TACE组相比，TAE组患者肝功能较差，乙肝感染率显著更高（P < 0.001）。倾向评分匹配后，选择504对匹配良好的中期HCC患者进行分析。单因素分析显示，与TAE相比，TACE显著延长了患者生存期（P < 0.001）。TACE组的1年、2年和3年OS率分别为74.3%、57.1%和44.4%，TAE组分别为58.3%、32.4%和21.7%。多因素分析显示，TACE治疗方法与TAE治疗方法相比，OS的风险比为0.517（95%CI，0.442 - 0.605；P < 0.001）。TACE组的总缓解率显著高于TAE组（35%对26%；P = 0.024）。