Comparative study of cisplatin and epirubicin in Tran catheter arterial chemoembolization for hepatocellular carcinoma
Comparative study of cisplatin and epirubicin in Tran catheter arterial chemoembolization for hepatocellular carcinoma
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顺铂与表柔比星Tran导管动脉化疗栓塞治疗肝细胞癌的对比研究
DOI：
10.1111/j.1872-034x.2010.00770.x
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发表时间：
2011
期刊：
影响因子：
4.2
通讯作者：
Uemoto S.
中科院分区：
文献类型：
--
作者：
Yamanaka K;Hatano E;Narita M;Taura K;Yasuchika K;Nitta T;Arizono S;Isoda H;Shibata T;Ikai I;Sato T;Uemoto S.
目的：经导管动脉化疗栓塞术（TACE）是治疗不可切除的肝细胞癌（HCC）的一种既定治疗方法。然而，目前尚不清楚TACE应选择哪种化疗药物。本研究的目的是比较顺铂（CDDP）与表阿霉素（EPI）在TACE治疗不可切除或复发的HCC患者的疗效。方法：我们进行了一项历史队列研究，涉及131例首次TACE治疗的患者，定义为首次治疗未经治疗的HCC或首次治疗复发的HCC后根治性切除或消融。结果：首次TACE联合CDDP和EPI的有效率分别为62.5%（20/32）和51.5%（51/99）。在肝切除术史、经皮治疗联合TACE和肿瘤因素的校正分析中，比值比为1.72（95%置信区间[CI]= 0.70-4.48）。 然而，肿瘤数量和化疗药物之间相互作用的检验具有统计学显著性（P= 0.016）。 在多发性肝癌中，CDDP和EPI的RR分别为66.7%（10/17）和39.6%（30/46）。 结论：CDDP在TACE治疗多发性肝癌中的疗效优于EPI。需要一项随机对照研究来阐明CDDP在多发性HCC患者TACE中的疗效。
Aim:Transcatheter arterial chemoembolization (TACE) is an established treatment for unresectable hepatocellular carcinoma (HCC). However, it is unclear which chemotherapeutic agent should be selected for TACE. The aim of this study was to compare the efficacy of cisplatin (CDDP) with that of epirubicin (EPI) in TACE for patients with unresectable or relapsed HCC.Methods:We performed a historical cohort study involving 131 patients treated with a first TACE, defined as either an initial treatment for previously untreated HCC or a first treatment for relapsed HCC after curative resections or ablations. Efficacy was estimated as the response rate (RR) and it was adjusted for the confounding factors that were defined in this study.Results:The RR were 62.5% (20/32) for the first TACE with CDDP and 51.5% (51/99) for that with EPI. In the adjusted analysis for a history of hepatectomy, percutaneous treatment combined with TACE and tumor factors, the odds ratio was 1.72 (95% confidence interval [CI] = 0.70–4.48). However, a test for interaction between the number of tumors and the chemotherapeutic agent was statistically significant (P= 0.016). In multiple HCC, the RR were 66.7% (10/17) for CDDP and 39.6% (30/46) for EPI. The odds ratio was 4.11 (95% CI = 1.14–17.2).Conclusion:CDDP may be more effective than EPI in TACE for multiple HCC. A randomized controlled study is needed to clarify the efficacy of CDDP in TACE in patients with multiple HCC.