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使用较小尺寸载药微球M1(DC Bead M1™)经动脉化疗栓塞术(TACE)治疗肝细胞癌的临床影响及重要技术要点:病例系列

Clinical Impact and Significant Technical Points of Transarterial Chemoembolization (TACE) Using the Smaller Drug-Eluting Bead M1 (DC Bead M1™) for Hepatocellular Carcinoma: A Case Series.

作者信息

Kawamura Yusuke, Akuta Norio, Yamamoto Shigeki, Eriksson Yasuka, Hosaka Tetsuya, Saitoh Satoshi, Sezaki Hitomi, Suzuki Fumitaka, Ikeda Kenji, Kumada Hiromitsu

机构信息

Hepatology, Toranomon Hospital, Tokyo, JPN.

Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, JPN.

出版信息

Cureus. 2024 Nov 25;16(11):e74415. doi: 10.7759/cureus.74415. eCollection 2024 Nov.

Abstract

BACKGROUND

This case series evaluated the clinical impact and significant technical points of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) using the smaller drug-eluting bead (DEB) M1 (DC Bead M1; 70-150 µm).

METHODS

We evaluated 12 patients and 14 HCC nodules treated with DEB-TACE using the DC Bead M1 (named DEM1-TACE). In addition to evaluating the early treatment efficacy for each treated node after DEM1-TACE, the study also used interventional radiology (IVR)- computed tomography (CT) to focus on the presence or absence of retention of the homogeneous contrast medium in target nodules after DEM1-TACE as a predictor of a good treatment response.

RESULTS

Nine HCC nodules (64%) showed a complete response by modified Response Evaluation Criteria in Solid Tumors (mRECIST), while two nodules (14%) had a partial response. Finally, 11 nodules (79%) showed an objective response (OR). Moreover, IVR-CT showed target nodules with retention of homogeneous contrast medium after DEM1-TACE, eight of nine (89%) nodules achieved a complete response and nine of nine (100%) nodules showed an OR, resulting in an objective response rate (ORR) of 100%. In contrast, in nodules without retention of homogeneous contrast medium in treated target nodules after DEM1-TACE, two of five (40%) nodules showed OR, resulting in an ORR of 40%. The ORR was significantly higher in the group with retention of homogeneous contrast medium after DEM1-TACE ( = 0.028).

CONCLUSIONS

DEM1-TACE had good treatment responses in patients with HCC. Evaluating retention of homogeneous contrast medium after DEM1-TACE using IVR-CT is one of the main predictors of treatment success.

摘要

背景

本病例系列评估了使用较小的载药微球(DEB)M1(DC Bead M1;70 - 150 µm)经动脉化疗栓塞术(TACE)治疗肝细胞癌(HCC)的临床影响和重要技术要点。

方法

我们评估了12例患者和14个接受DC Bead M1经动脉化疗栓塞术(称为DEM1 - TACE)治疗的HCC结节。除了评估DEM1 - TACE后每个治疗结节的早期治疗效果外,该研究还使用介入放射学(IVR) - 计算机断层扫描(CT)重点关注DEM1 - TACE后靶结节中是否存在均匀造影剂滞留,以此作为良好治疗反应的预测指标。

结果

根据实体瘤改良反应评估标准(mRECIST),9个HCC结节(64%)显示完全缓解,而2个结节(14%)部分缓解。最终,11个结节(79%)显示客观反应(OR)。此外,IVR - CT显示DEM1 - TACE后靶结节有均匀造影剂滞留,9个结节中的8个(89%)实现完全缓解,9个结节中的9个(100%)显示客观反应,客观反应率(ORR)为100%。相比之下,在DEM1 - TACE后治疗的靶结节中无均匀造影剂滞留的结节中,5个结节中的2个(40%)显示客观反应,客观反应率为40%。DEM1 - TACE后有均匀造影剂滞留组的客观反应率显著更高(P = 0.028)。

结论

DEM1 - TACE对HCC患者有良好的治疗反应。使用IVR - CT评估DEM1 - TACE后均匀造影剂滞留情况是治疗成功的主要预测指标之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b50f/11669395/e5f7589ebb1c/cureus-0016-00000074415-i01.jpg

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