Comparison of Local Control in Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma aparts per thousandcurrency sign6 cm With or Without Intraprocedural Monitoring of the Embolized Area Using Cone-Beam Computed Tomography

Comparison of Local Control in Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma aparts per thousandcurrency sign6 cm With or Without Intraprocedural Monitoring of the Embolized Area Using Cone-Beam Computed Tomography
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DOI:
10.1007/s00270-013-0667-2
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发表时间:
2014-04-01
影响因子:
2.9
通讯作者:
Matsui, Osamu
Matsui, Osamu
中科院分区:
医学3区
文献类型:
--
作者:
Miyayama, Shiro;Yamashiro, Masashi;Matsui, Osamu

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本研究旨在比较经导管动脉化疗栓塞术 (TACE) 治疗肝细胞癌 (HCC) 的技术成功率和局部复发率,无论是否使用锥形束计算机断层扫描 (CBCT) 监测栓塞区域。仅使用数字减影血管造影 (DSA) 的超选择性 TACE 治疗了总共 207 个千分之一货币符号 6 cm 的 HCC(DSA 组,70 名患者的 98 个肿瘤)或加CBCT监测(CBCT组,79例患者109个肿瘤)。 TACE的技术成功根据1周CT分为三级;肿瘤有安全边缘栓塞(<25mm的肿瘤为5mm宽,千分之25a的肿瘤为10mm宽,货币符号为60mm的千分之10mm;A级),部分无安全边缘(B级),或整个肿瘤未栓塞(C级)。比较了 DSA 和 CBCT 组的技术成功率和局部复发率。比较A级和B级肿瘤的局部复发率。DSA组和CBCT组的A/B/C级肿瘤分别为64(65.3%)/25(25.5%)/9(9.2%)和95(87.2%)/11(10.1%)/3(2.8%)。 46/158 (29.1 %) A 级肿瘤和 24/36 (66.7 %) B 级肿瘤发生局部复发。DSA 和 CBCT 组之间的技术成功率存在显着差异 (p < 0.001),A 级和 B 级肿瘤之间的局部复发率存在显着差异 (p < 0.001)。 DSA 组和 CBCT 组的 1 年、2 年和 3 年局部复发率分别为 33.3 % 和 22.3 %、41.3 % 和 26.8 %、48 % 和 30.6 % (p = 0.0217)。术中 CBCT 监测栓塞区域可减少局部肿瘤复发。
This study was designed to compare technical success and local recurrence rates of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) with/without monitoring of embolized areas using cone-beam computed tomography (CBCT).A total of 207 HCCs a parts per thousand currency sign6 cm were treated with superselective TACE using digital subtraction angiography (DSA) alone (DSA group, 98 tumors of 70 patients) or plus CBCT monitoring (CBCT group, 109 tumors of 79 patients). Technical success of TACE was classified into three grades according to 1-week CT; the tumor was embolized with a safety margin (5-mm wide for tumors < 25 mm, and 10-mm wide for tumors 25a parts per thousand yen and a parts per thousand currency sign60 mm; grade A), without a margin in parts (grade B), or the entire tumor was not embolized (grade C). Technical success and local recurrence rates in the DSA and CBCT groups were compared. Local recurrence rates of grade A and B tumors were also compared.The grade A/B/C tumors in the DSA and CBCT groups were 64 (65.3 %)/25 (25.5 %)/9 (9.2 %) and 95 (87.2 %)/11 (10.1 %)/3 (2.8 %), respectively. Local recurrence developed in 46/158 (29.1 %) grade A tumors and 24/36 (66.7 %) grade B. There were significant differences in technical success between the DSA and CBCT groups (p < 0.001) and local recurrence rates between grade A and B tumors (p < 0.001). The 1-, 2-, and 3-year local recurrence rates in the DSA and CBCT groups were 33.3 and 22.3 %, 41.3 and 26.8 %, and 48 and 30.6 %, respectively (p = 0.0217).Intraprocedural CBCT monitoring of embolized areas reduces the local tumor recurrence.