Transarterial Chemoembolization for Hepatocellular Carcinoma with Drug-Eluting Microspheres: Preliminary Results from an Italian Multicentre Study
Transarterial Chemoembolization for Hepatocellular Carcinoma with Drug-Eluting Microspheres: Preliminary Results from an Italian Multicentre Study
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DOI：
10.1007/s00270-008-9409-2
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发表时间：
2008-11-01
影响因子：
2.9
通讯作者：
Sarti, Ilaria
中科院分区：
文献类型：
--
作者：
Grosso, Maurizio;Vignali, Claudio;Sarti, Ilaria
本文的目的是介绍一项多中心试验的早期结果，该试验使用载有化疗药物的 HepaSphere 微球对不可切除的肝细胞癌患者进行经动脉化疗栓塞 (TACE)。从2005年12月到2007年3月，50名患者（36名男性和14名女性，平均年龄68.4岁）接受了选择性TACE，使用负载阿霉素或表柔比星的HepaSphere微球。治疗病灶的直径范围为 20 至 100 毫米（平均 42.5；最多 4 个肿瘤结节）。根据欧洲肝病研究协会修改的世界卫生组织标准，通过计算机轴向断层扫描评估肿瘤反应。所有手术在技术上都很成功，并且没有出现重大并发症。 1个月随访时，50名患者中有24名（48%）肿瘤完全缓解，50名患者中有18名（36%）部分缓解，50名患者中有8名（16%）疾病稳定，没有疾病进展的病例。在 6 个月的随访中（50 名患者中的 31 名），31 名患者中的 16 名（51.6%）获得肿瘤完全缓解，31 名患者中的 8 名（25.8%）获得部分缓解，31 名患者中的 7 名（22.6%）获得疾病进展。在最初的 9 个月随访中，3 名患者成功重复使用 HepaSphere 的 TACE 两次，而 3 名患者接受了 3 次手术。我们最初的多中心经验表明，使用 HepaSphere 的 TACE 是可行的，耐受性良好，并发症发生率低，并且与有希望的肿瘤反应相关。当肿瘤未达到完全缓解时，可以毫无困难地进行额外的治疗。为了确认这些初步结果，必须对更大的系列进行更长时间的跟踪。
The purpose of this article is to present the early results of a multicentre trial using HepaSphere microspheres loaded with chemotherapeutic agents for transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma. From December 2005 to March 2007, 50 patients (36 male and 14 female, mean age 68.4 years) were treated by selective TACE using HepaSphere microspheres loaded with doxorubicin or epirubicin. The diameter of the treated lesions ranged from 20 to 100 mm (mean 42.5; maximum of 4 tumor nodules). Tumor response was evaluated by computed axial tomography according to the World Health Organization criteria as modified by the European Association for the Study of Liver Diseases. All of the procedures were technically successful, and there were no major complications. At 1-month follow-up, complete tumor response was observed in 24 of 50 (48%), partial response in 18 of 50 (36%), and stable disease in 8 of 50 (16%) patients, and there were no cases of disease progression. At 6-month follow-up (31 of 50 patients), complete tumor response was obtained in 16 of 31 (51.6%), partial response in 8 of 31 (25.8%), and progressive disease in 7 of 31 (22.6%) patients. Within the initial 9-month follow-up, TACE with HepaSphere was successfully repeated twice in 3 patients, whereas 3 patients underwent the procedure 3 times. Our initial multicentre experience demonstrates that TACE using HepaSphere is feasible, is well tolerated, has a low complication rate, and is associated with promising tumor response. When complete tumor response in not achieved, additional treatments can be performed without difficulties. Longer follow-up on larger series is mandatory to confirm these preliminary results.