肝细胞癌患者接受经动脉放射栓塞术作为一线介入疗法和既往接受过经动脉化疗栓塞术后的疗效

J. Wagenpfeil, P. Kupczyk, Philipp Bruners, Robert Siepmann, Emelie Guendel, J. Luetkens, A. Isaak, Carsten Meyer, Fabian Kuetting, Claus C Pieper, U. Attenberger, D. Kuetting
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引用次数: 0

摘要

由于缺乏数据,关于无法切除的肝细胞癌(HCC)的最佳一线介入疗法的争论一直存在。这项研究的目的是比较经动脉放射栓塞术(TARE)作为一线疗法和作为经动脉化疗栓塞术(TACE)后的后续疗法对这些患者的治疗效果。共对83名患者进行了评估,其中38名患者在TARE之前至少接受过一次TACE治疗[27名男性;平均年龄67.2岁;68.4%为巴塞罗那临床肝癌(BCLC)B期,31.6%为BCLC C期];45名患者接受了初级TARE治疗(33名男性;平均年龄69.9岁;40%为BCLC B期,58%为BCLC C期)。比较了临床[年龄、性别、BCLC分期、以千兆贝克勒尔(GBq)为单位的活性、Child-Pugh状态、门静脉血栓形成、肿瘤体积]和程序[总生存期(OS)、局部肿瘤控制(LTC)和无进展生存期(PFS)]数据。结果显示,OS(95% CI:1.12,P = 0.289)、LTC(95% CI:0.003,P = 0.95)和PFS(95% CI:0.4,P = 0.525)均无差异。回归分析显示,Child-Pugh 评分(P = 0.005)、HCC 病灶大小(>10 厘米)(P = 0.022)与 OS 之间存在关系;既往 TACE(Child-Pugh B 患者;95% CI:0.120,P = 0.729)和病灶数量(>10;95% CI:2.930,P = 0.087)均与 OS 无关。
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Outcome of transarterial radioembolization in patients with hepatocellular carcinoma as a first-line interventional therapy and after a previous transarterial chemoembolization
Due to a lack of data, there is an ongoing debate regarding the optimal frontline interventional therapy for unresectable hepatocellular carcinoma (HCC). The aim of the study is to compare the results of transarterial radioembolization (TARE) as the first-line therapy and as a subsequent therapy following prior transarterial chemoembolization (TACE) in these patients.A total of 83 patients were evaluated, with 38 patients having undergone at least one TACE session prior to TARE [27 male; mean age 67.2 years; 68.4% stage Barcelona clinic liver cancer (BCLC) B, 31.6% BCLC C]; 45 patients underwent primary TARE (33 male; mean age 69.9 years; 40% BCLC B, 58% BCLC C). Clinical [age, gender, BCLC stage, activity in gigabecquerel (GBq), Child–Pugh status, portal vein thrombosis, tumor volume] and procedural [overall survival (OS), local tumor control (LTC), and progression-free survival (PFS)] data were compared. A regression analysis was performed to evaluate OS, LTC, and PFS.No differences were found in OS (95% CI: 1.12, P = 0.289), LTC (95% CI: 0.003, P = 0.95), and PFS (95% CI: 0.4, P = 0.525). The regression analysis revealed a relationship between Child–Pugh score (P = 0.005), size of HCC lesions (>10 cm) (P = 0.022), and OS; neither prior TACE (Child–Pugh B patients; 95% CI: 0.120, P = 0.729) nor number of lesions (>10; 95% CI: 2.930, P = 0.087) correlated with OS.Prior TACE does not affect the outcome of TARE in unresectable HCC.
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