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基于经动脉化疗栓塞的多模式治疗对累及肝脏的神经内分泌肿瘤患者的疗效

Efficacy of transcatheter arterial chemoembolization-based multimodal treatment in patients with neuroendocrine tumors involving the liver.

作者信息

Xu Hu, Zhang Li, Zhang Juan, Chen Yi, Ge Ningling, Gan Yuhong, Chen Rongxin, Chen Maopei

机构信息

Department of Intervention Medicine, Affiliated Tumor Hospital of Nantong University, Nantong, China.

Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

Transl Cancer Res. 2025 Jul 30;14(7):4321-4330. doi: 10.21037/tcr-2024-2482. Epub 2025 Jul 17.

Abstract

BACKGROUND

Neuroendocrine tumors (NETs) are a group of heterogeneous diseases which have liver dominant involvement potency. The value of transcatheter arterial chemoembolization (TACE) treatment for NET patients in the era of somatostatin analogues (SSAs) and anti-proliferation agents needs further study. The study aimed to investigate the value of TACE-based treatment for NETs involving the liver.

METHODS

A group of 29 NET patients received TACE-based multimodal treatment in the Department of Hepatic Oncology of Zhongshan Hospital, Fudan University was retrospectively collected. Baseline characteristics of included patients were analyzed. Kaplan-Meier analysis and Cox proportional hazards regression were used to investigate clinical and pathological parameters on overall survival (OS) and progression free-survival (PFS) in NET patients.

RESULTS

The median OS and PFS were 20.0 [95% confidence interval (CI): 13.4-26.5] months and 11.0 (95% CI: 7.7-14.3) months, respectively. Tumor grade (P=0.001), number of TACE treatments (P=0.003), neutrophil to lymphocyte ratio (NLR) (P=0.005) and systemic treatment mode (P=0.007) were significantly associated with OS while tumor grade (P<0.001), number of TACE treatments (P=0.002), aspartate aminotransferase (AST) (P=0.01) and systemic treatment mode (P=0.001) were of significance to PFS in multivariate Cox regression analyses.

CONCLUSIONS

TACE-based multimodal treatment is beneficial for NETs involving the liver. The sequence and timing of local treatment and systemic treatment allocation need further investigation.

摘要

背景

神经内分泌肿瘤(NETs)是一组具有肝脏优势受累倾向的异质性疾病。在生长抑素类似物(SSAs)和抗增殖药物时代,经动脉化疗栓塞(TACE)治疗NET患者的价值需要进一步研究。本研究旨在探讨以TACE为基础的治疗对累及肝脏的NETs的价值。

方法

回顾性收集复旦大学附属中山医院肝肿瘤内科一组29例接受以TACE为基础的多模式治疗的NET患者。分析纳入患者的基线特征。采用Kaplan-Meier分析和Cox比例风险回归研究NET患者总生存(OS)和无进展生存(PFS)的临床和病理参数。

结果

中位OS和PFS分别为20.0[95%置信区间(CI):13.4 - 26.5]个月和11.0(95%CI:7.7 - 14.3)个月。在多因素Cox回归分析中,肿瘤分级(P = 0.001)、TACE治疗次数(P = 0.003)、中性粒细胞与淋巴细胞比值(NLR)(P = 0.005)和全身治疗模式(P = 0.007)与OS显著相关,而肿瘤分级(P < 0.001)、TACE治疗次数(P = 0.002)、天冬氨酸转氨酶(AST)(P = 0.01)和全身治疗模式(P = 0.001)对PFS具有显著意义。

结论

以TACE为基础的多模式治疗对累及肝脏的NETs有益。局部治疗和全身治疗分配的顺序和时机需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b8a/12335680/350658824e83/tcr-14-07-4321-f1.jpg

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