Doxorubicin-loaded drug-eluting beads versus conventional transarterial chemoembolization for nonresectable hepatocellular carcinoma.
Doxorubicin-loaded drug-eluting beads versus conventional transarterial chemoembolization for nonresectable hepatocellular carcinoma.
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DOI：
10.4103/1319-3767.157571
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发表时间：
2015-05
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影响因子：
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通讯作者：
Al-Otaibi M
中科院分区：
文献类型：
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作者：
Arabi M;BenMousa A;Bzeizi K;Garad F;Ahmed I;Al-Otaibi M
比较多柔比星药物洗脱微球（DEB）与传统TACE（C-TACE）治疗不可切除肝细胞癌（HCC）的疗效和安全性。本回顾性研究纳入了2006-2014年期间接受c-TACE或DEB-TACE且符合入选标准的所有不可切除HCC患者。主要终点为首次影像学随访时的肿瘤缓解率、治疗相关肝毒性和治疗后出现的不良事件（TEAE）。DEB-TACE组35例患者（51例手术）和c-TACE组19例患者（25例手术）被纳入分析。DEB-TACE组患者的中位随访时间为61天（范围24-538天），c-TACE组患者为86天（范围3-152天）。DEB = TACE组的完全缓解（CR）、客观缓解（OR）、疾病控制（DC）和疾病进展（PD）率分别为11%、24%、53%和47%，而c-TACE组分别为4%、32%、64%和36%。与c-TACE组相比，DEB-TACE组患者的平均ALT较基线变化极小（7.2 vs 79.4单位，P = 0.001）。DEB-TACE组的住院时间显著更短（7.8天vs 11.4天; P = 0.038）。c-TACE组患者的2年生存率为60%，DEB-TACE组为58%（P = 0.4）。与c-TACE相比，DEB-TACE的肝毒性获益更小，耐受性更好，住院时间更短。然而，这两种模式具有相似的生存和疗效益处。
To compare the efficacy and safety profile of doxorubicin-loaded drug-eluting beads (DEB) to the conventional TACE (C-TACE) in the management of nonresectable hepatocellular carcinoma (HCC). All patients with nonresectable HCC who underwent either c-TACE or DEB-TACE during the period 2006–2014 and fulfilled the inclusion criteria were included in this retrospective study. Primary endpoints were tumor response rate at first imaging follow up, treatment-related liver toxicity, and treatment emergent adverse events (TEAE). Thirty-five patients (51 procedures) in the DEB-TACE group and 19 patients (25 procedures) in the c-TACE group were included in the analysis. The median follow up time was 61 days (range 24–538 days) in the DEB-TACE group and 86 days (range 3–152 days) for the c-TACE group patients. Complete response (CR), objective response (OR), disease control (DC), and progressive disease (PD) rates were 11%, 24%, 53%, and 47%, respectively, in the DEB = TACE group compared with 4%, 32%, 64%, and 36%, respectively, in the c-TACE group. Mean ALT change from baseline was minimal in the DEB-TACE patients compared with c-TACE group (7.2 vs 79.4 units, P = 0.001). Hospital stay was significantly shorter in the DEB-TACE group (7.8 days vs 11.4 days; P = 0.038). The 2-year survival rate was 60% for the c-TACE patients and 58% for the DEB-TACE (P = 0.4). DEB-TACE compared with c-TACE is associated with lesser liver toxicity benefit, better tolerance, and shorter hospital stay. The two modalities however had similar survival and efficacy benefits.