Chemoembolization for Hepatocellular Carcinoma: Comprehensive Imaging and Survival Analysis in a 172-Patient Cohort
Chemoembolization for Hepatocellular Carcinoma: Comprehensive Imaging and Survival Analysis in a 172-Patient Cohort
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DOI：
10.1148/radiol.10091473
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发表时间：
2010-06-01
期刊：
影响因子：
19.7
通讯作者：
Salem, Riad
中科院分区：
文献类型：
--
作者：
Lewandowski, Robert J.;Mulcahy, Mary F.;Salem, Riad
目的：为了确定全面的成像和长期生存的结果，化疗栓塞后肝细胞癌（HCC）hematopoiet.Materials和方法：一百七十二例肝癌化疗栓塞治疗的回顾性研究机构审查委员会批准的协议，这项研究是符合健康保险及责任法案。获得基线实验室和影像学特征。评估治疗后的临床和实验室毒性。评价化疗栓塞后的影像学特征，以确定缓解率（大小和坏死）和疾病进展时间（TTP）。计算从首次化疗栓塞治疗开始的生存率。根据Child-Pugh，器官共享联合网络和巴塞罗那肝癌临床（BCLC）分期systems.Results：肝硬化是目前在157例（91%），门脉高压症是目前在139例（81%）进行了亚组分析。11例患者（6%）在基线时有转移。11例患者（6%）存在门静脉血栓形成。55%的患者在治疗后出现了某种形式的毒性; 21%的患者出现了3级或4级胆红素毒性。根据大小和坏死标准，分别在31%和64%的患者中观察到化疗栓塞后反应。中位TTP为7.9个月（95%置信区间：7.1，9.4），但不同阶段差异很大。BCLC A、B和C期患者的中位生存期存在显著差异（A期，40.0个月; B，17.4个月; C，6.3个月; P < .0001）。结论：HCC患者TTP和生存期的确定受到肿瘤生物学和背景肝硬化的混淆;化疗栓塞被证明是HCC患者安全有效的治疗方法。(c)RSNA，2010年
Purpose: To determine comprehensive imaging and long-term survival outcome following chemoembolization for hepatocellular carcinoma (HCC).Materials and Methods: One hundred seventy-two patients with HCC treated with chemoembolization were studied retrospectively in an institutional review board approved protocol; this study was HIPAA compliant. Baseline laboratory and imaging characteristics were obtained. Clinical and laboratory toxicities following treatment were assessed. Imaging characteristics following chemoembolization were evaluated to determine response rates (size and necrosis) and time to progression (TTP). Survival from the time of first chemoembolization treatment was calculated. Subanalyses were performed by stratifying the population according to Child-Pugh, United Network for Organ Sharing, and Barcelona Clinic for Liver Cancer (BCLC) staging systems.Results: Cirrhosis was present in 157 patients (91%); portal hypertension was present in 139 patients (81%). Eleven patients (6%) had metastases at baseline. Portal vein thrombosis was present in 11 patients (6%). Fifty-five percent of patients experienced some form of toxicity following treatment; 21% developed grade 3 or 4 bilirubin toxicity. Post-chemoembolization response was seen in 31% and 64% of patients according to size and necrosis criteria, respectively. Median TTP was 7.9 months (95% confidence interval: 7.1, 9.4) but varied widely by stage. Median survival was significantly different between patients with BCLC stages A, B, and C disease (stage A, 40.0 months; B, 17.4 months; C, 6.3 months; P < .0001).Conclusion: The determination of TTP and survival in patients with HCC is confounded by tumor biology and background cirrhosis; chemoembolization was shown to be a safe and effective therapy in patients with HCC. (c) RSNA, 2010