Predictive factors for complete response of chemoembolization with drug-eluting beads (DEB-TACE) for hepatocellular carcinoma
Predictive factors for complete response of chemoembolization with drug-eluting beads (DEB-TACE) for hepatocellular carcinoma
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DOI：
10.1007/s00330-015-3982-y
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发表时间：
2016-06-01
影响因子：
5.9
通讯作者：
Tasu, Jean-Pierre
中科院分区：
文献类型：
--
作者：
Vesselle, Guillaume;Quirier-Leleu, Camille;Tasu, Jean-Pierre
为了确定肝细胞癌患者首次使用药物洗脱微球（DEB）经动脉化疗栓塞（TACE）完全缓解（CR）相关的临床和影像学特征，在该前瞻性历史队列中，研究了2007年至2013年至少接受过一次DEB-TACE的172例患者（315个肿瘤）。根据改良的实体瘤疗效评价标准（mRECIST）评价影像学缓解。年龄，性别，肝硬化的病因，Child和BCLC评分，颗粒大小，在肝脏中的位置，肿瘤的大小，胶囊的存在，DSA和CT/MRI扫描上的血管增生，以及脸红消退进行了分析。病灶大小、在肝脏中的位置和DSA上的完全脸红消退与完全缓解具有统计学相关性，而影像学和人口统计学标准上的胶囊方面则无相关性。仅在多变量分析中，肝脏中的位置和结节大小是显著特征。肿瘤位于第1和第4节段是CR的不利因素，而肿瘤大小< 5 cm是阳性预测因素。因此，可以考虑这些标准，以改善DEB-TACE患者的选择。a关于DEB-TACE后完全缓解的预测因素的文献研究不足。a肿瘤大小< 5 cm与完全缓解相关。a位于节段1或4是缓解的不利因素。a没有人口统计学参数影响完全缓解。
To identify clinical and imaging features associated with complete response (CR) to first session of transarterial chemoembolization (TACE) with drug-eluting beads (DEB) in patients with hepatocellular carcinoma.In this prospective historical cohort, 172 patients with 315 tumours who received at least one DEB-TACE from 2007 to 2013 were studied. Imaging response was evaluated according to the modified Response Evaluation Criteria in Solid Tumours (mRECIST). Age, gender, aetiology of cirrhosis, Child and BCLC scores, particles size, location in the liver, size of the tumour, presence of a capsule, hypervascularisation on DSA and CT/MRI scans, and blush extinction were analysed.After one session of treatment, CR was observed in 36 % of the 315 tumours treated. Nodule size, location in the liver, and complete blush extinction on DSA was statistically correlated to complete response, whereas capsule aspect on imaging and demographic criteria were not. In multivariate analysis only, location in the liver and nodule size were significant features.Tumour location in the segments 1 and 4 is a pejorative factor for CR, whereas tumour size < 5 cm is a positive predictive factor. These criteria could, therefore, be taken into consideration to improve the selection of patients for DEB-TACE.aEuro cent Literature on predictive factors of complete response after DEB-TACE is under-studied.aEuro cent Tumour size < 5 cm is associated with complete response.aEuro cent Location in segments 1 or 4 is a pejorative factor for response.aEuro cent No demographic parameter influences complete response.