Vogl Thomas J, Stefan Hannah, Gruber-Rouh Tatjana, Trojan Jörg, Bechstein Wolf Otto, Bielfeldt John, Adwan Hamzah
Clinic for Radiology and Nuclear Medicine, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
Department of Gastroenterology, Hepatology and Endocrinology, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
J Cancer Res Clin Oncol. 2024 Oct 1;150(10):440. doi: 10.1007/s00432-024-05951-8.
This study aimed to compare the combination therapy of transarterial chemoembolization (TACE) and microwave ablation (MWA) with MWA alone in treating liver metastases from colorectal cancer (LMCRC).
In this retrospective study, a total of 251 patients with unresectable and not to chemotherapy responding LMCRC were included. Group A consisted of 184 patients (104 male and 80 females; mean age: 64 ± 11.4 years) with 442 metastases who received a combination of TACE and MWA. A total of 67 patients (49 male and 18 females; mean age: 63.2 ± 11.8 years) with 173 metastases patients were included in group B, who received only MWA. Parameters assessed were local tumor progression (LTP), hepatic distant tumor progression (hDTP), hepatic progression-free survival (hPFS), and overall survival (OS).
The rate of LTP was 4.9% in group A and 4.5% in group B (p-value: 0.062). The rate of hDTP was 71.7% and 83.6% for groups A and B (p-value: 0.81), respectively. The mean hPFS was 13.8 months (95% CI 10.9-16.8) for group A and 8.1 months (95% CI 6.1-10.1) for group B (p-value: 0.03). The median OS time for group A was 30 months (95% CI 26-34), with 1-, 2-, 3-, and 4-year OS rates of 84.2%, 61.1%, 40.8% and 31.3%, respectively. In group B however, the median OS time was 26 months (95% CI 18-34) with 1-, 2-, 3-, and 4-year OS rates of 82.3%, 53.2%, 34.6% and 28.2%, respectively (p-value: 0.67).
The combination therapy of TACE and MWA is superior to the monotherapy of MWA for LMCRC, especially regarding hDTP, hPFS and OS.
本研究旨在比较经动脉化疗栓塞术（TACE）联合微波消融术（MWA）与单纯MWA治疗结直肠癌肝转移（LMCRC）的疗效。
在这项回顾性研究中，共纳入251例无法切除且对化疗无反应的LMCRC患者。A组由184例患者（男104例，女80例；平均年龄：64±11.4岁）组成，有442个转移灶，接受了TACE和MWA联合治疗。B组共纳入67例患者（男49例，女18例；平均年龄：63.2±11.8岁），有173个转移灶，仅接受MWA治疗。评估的参数包括局部肿瘤进展（LTP）、肝远处肿瘤进展（hDTP）、肝无进展生存期（hPFS）和总生存期（OS）。
A组的LTP发生率为4.9%，B组为4.5%（p值：0.062）。A组和B组的hDTP发生率分别为71.7%和83.6%（p值：0.81）。A组的平均hPFS为13.8个月（95%CI 10.9 - 16.8），B组为8.1个月（95%CI 6.1 - 10.1）（p值：0.03）。A组的中位OS时间为30个月（95%CI 26 - 34），1年、2年、3年和4年的OS率分别为84.2%、61.1%、40.8%和31.3%。然而，B组的中位OS时间为26个月（95%CI 18 - 34），1年、2年、3年和4年的OS率分别为82.3%、53.2%、34.6%和28.2%（p值：0.67）。
对于LMCRC，TACE联合MWA的联合治疗优于单纯MWA治疗，尤其是在hDTP、hPFS和OS方面。
