载药微球经肝动脉化疗栓塞术治疗不可切除原发性肝癌的疗效与安全性

Efficacy and safety of transhepatic arterial chemoembolization with drug-loaded microspheres in unresectable primary liver cancer.

作者信息

Deng Jun, Mi Yan-Hong, Xie Le, Sun Xiong-Xing, Liu Dan-Hong, Long Hua-Jun, He Li-Yong, Wu Da-Hua, Shang Hong-Cai

机构信息

Department of Integrated Traditional Chinese and Western Medicine, Hunan University of Traditional Chinese Medicine, Changsha 410208, Hunan Province, China.

Department of Neurology, Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Changsha 410208, Hunan Province, China.

出版信息

World J Gastrointest Oncol. 2024 Dec 15;16(12):4728-4737. doi: 10.4251/wjgo.v16.i12.4728.

DOI:10.4251/wjgo.v16.i12.4728

PMID:39678808

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11577372/

Abstract

BACKGROUND

Transhepatic arterial chemoembolization (TACE), as a local treatment, has been widely used in the treatment of unresectable liver cancer. The introduction of drug carrier microspheres has brought new hope for the therapeutic effect of TACE. Microspheres can realize the slow release and directional delivery of drugs, reduce systemic toxicity and improve local curative effect.

AIM

To compare the effectiveness of traditional transcatheter arterial chemoembolization against microsphere-assisted transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma that is incurable.

METHODS

We searched the PubMed, Embase, Cochrane Library, and CNKI databases for clinical trials of drug-luting beads TACE (DEB-TACE) conventional TACE (cTACE) for the treatment of unresectable liver cancer. We screened references based on inclusion and exclusion criteria and then selected valid data for meta-analysis using RevMan 53 software. The complete response (CR) rate, partial response (PR) rate, postoperative stable disease (SD) rate, and 6-month and 12-month survival rates were compared.

RESULTS

A total of 12 articles were included, including 1177 patients, 519 of whom received DEB-TACE and 658 of whom received cTACE. The CR rate in the DEB-TACE group was much greater than that in the cTACE group [relative risk (RR) = 1.42, 95%CI: 1.18-1.72, = 0.0002]. The 12-month survival rate significantly increased (RR = 1.09; 95%CI: 1.01- 1.17, = 0.03); the PR rate (RR = 1.13; 95%CI: 0.97-1.30, = 0.12); the SD rate (RR = 0.82; 95%CI: 0.64-1.05, = 0.12); and the 6-month survival rate (RR = 1.05; 95%CI: 1.00-1.10, = 0.07). There was no significant difference ( < 0.05).

CONCLUSION

Compared with those of iodized oil TACE, the drug-loaded microspheres tended to have therapeutic advantages.

摘要

背景

经肝动脉化疗栓塞术（TACE）作为一种局部治疗方法，已广泛应用于不可切除肝癌的治疗。药物载体微球的引入为TACE的治疗效果带来了新希望。微球可实现药物的缓释和定向递送，降低全身毒性并提高局部疗效。

目的

比较传统经导管动脉化疗栓塞术与微球辅助经导管动脉化疗栓塞术治疗无法治愈的肝细胞癌的有效性。

方法

我们在PubMed、Embase、Cochrane图书馆和中国知网数据库中检索了载药微球TACE（DEB-TACE）与传统TACE（cTACE）治疗不可切除肝癌的临床试验。我们根据纳入和排除标准筛选参考文献，然后使用RevMan 53软件选择有效数据进行荟萃分析。比较完全缓解（CR）率、部分缓解（PR）率、术后疾病稳定（SD）率以及6个月和12个月生存率。

结果

共纳入12篇文章，包括1177例患者，其中519例接受DEB-TACE，658例接受cTACE。DEB-TACE组的CR率远高于cTACE组[相对危险度（RR）=1.42，95%置信区间：1.18 - 1.72，P = 0.0002]。12个月生存率显著提高（RR = 1.09；95%置信区间：1.01 - 1.17，P = 0.03）；PR率（RR = 1.13；95%置信区间：0.97 - 1.30，P = 0.12）；SD率（RR = 0.82；95%置信区间：0.64 - 1.05，P = 0.12）；6个月生存率（RR = 1.05；95%置信区间：1.00 - 1.10，P = 0.07）。差异无统计学意义（P < 0.05）。