A comprehensive intervention on feasibility, efficacy, and safety between TAE combined with multi-applicator ablation therapy and TACE in the treatment of large hepatocellular carcinoma.
A comprehensive intervention on feasibility, efficacy, and safety between TAE combined with multi-applicator ablation therapy and TACE in the treatment of large hepatocellular carcinoma.
复制标题
TAE联合多头消融治疗与TACE治疗大肝癌的可行性、有效性和安全性综合干预
DOI：
10.21037/tcr-20-293
复制
发表时间：
2020-10
影响因子：
0.9
通讯作者：
Zhang J
中科院分区：
文献类型：
--
作者：
Mahara G;Chen G;Ge Q;Lin Z;Huang J;Zhang J
背景肝细胞癌（Hepatocellular carcinoma，HCC）是近年来最常见的恶性肿瘤之一，死亡率高，早期诊断率低，已成为全球第四大死亡原因。本研究旨在评价经导管动脉栓塞（TAE）治疗联合多个施源器消融与经动脉化疗栓塞（TACE）治疗大肝癌的可行性、有效性和安全性。方法在广州中山大学肿瘤防治中心进行的一项干预性研究。通过重复测量方差分析、Mann-Whitney U秩和检验在不同时间维度评价两组（干预组和对照组）之间的比较，其中Kaplan-Meier和对数秩检验计算总生存期（OS）、肿瘤缓解（TR）和无进展生存期（PFS）。结果观察组1年生存率（SR）和无进展生存率（PFS）分别提高56.4%和12.8%，对照组分别提高38.3%和8.5%。同样，I组的1年和2年OS率（OSR）分别为66.7%和51.4%，II组分别为48.9%和30.0%。Ⅰ组近期疗效完全缓解（CR）、部分缓解（PR）、稳定（SD）、进展（PD）分别为28.21%、56.41%、0、15.38%; Ⅱ组近期疗效完全缓解（CR）、部分缓解（PR）、稳定（SD）、进展（PD）分别为2.13%、68.79%、6.38%、22.70%。近期疗效Ⅰ组优于Ⅱ组。生活质量I组优于II组。结论TAE联合多点消融治疗大肝癌较TACE治疗安全、有效、生存期长、不良反应轻。
Background Hepatocellular carcinoma (HCC) is one of the most common tumors in recent days with high mortality and low early diagnosis rate, resulting in the fourth leading cause of deaths globally. This study aimed to evaluate the feasibility, efficacy, and safety between transcatheter arterial embolization (TAE) therapy followed by multi-applicator ablation and transarterial chemoembolization (TACE) for the treatment of large HCC. Methods An intervention study conducted at the Cancer Center of Sun Yat-sen University, Guangzhou, China, with whom had large HCC. A comparison between the two groups (intervention and control group) was evaluated at different time dimensions by repeated-measures analysis of variance, Mann-Whitney U rank-sum test, where Kaplan-Meier and log-rank test calculated for the overall survival (OS), tumor response (TR), and progression-free survival (PFS). Results This study found the improved survival rate (SR) and PFS after 1-year treatment in the observation group (Group-I) by 56.4% and 12.8%, compared to 38.3% and 8.5% in the control group (Group-II). Likewise, 1- and 2-year OS rates (OSRs) in Group-I were 66.7% and 51.4%, wherein Group-II were 48.9% and 30.0%, respectively. The short-term efficacy of Group-I, such as complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD) were 28.21%, 56.41%, 0, 15.38%, while in Group-II was 2.13%, 68.79%, 6.38% 22.70% respectively, which were significant. The short-term efficacy was more excellent in the Group-I than Group-II. The quality of life (QOL) was better in Group-I than that of Group-II. Conclusions TAE combined with multi-applicator ablation therapy is safer, effective with prolonged survival, and less severe adverse reactions compared to TACE therapy for the treatment of large HCC.