摘要
目的研究超液态碘化油联合药物洗脱微球经动脉化疗栓塞术(TACE)治疗巴塞罗那(BCLC) B/C期肝细胞癌(HCC)的有效性和安全性。方法回顾性分析2016年5月-2018年9月苏州大学附属第一医院接受超液态碘化油联合药物洗脱微球栓塞治疗的51例BCLC B/C期HCC患者,比较治疗前和治疗后3 d、7 d、1个月的肝功能变化,详细记录不良反应及并发症发生情况,采用改良实体瘤疗效评价标准(mRECIST)评价术后1、3个月临床疗效。计量资料组间比较采用t检验。结果 51例患者均完成超选择栓塞,治疗病灶术后1个月疾病缓解率为70. 6%,疾病控制率为96. 1%;3个月疾病缓解率为64. 0%,疾病控制率为88. 0%。术后3 d急性肝损伤发生率9. 8%(5/51),ALT、AST、TBil、Alb变化较术前有明显差异(t值分别为-5. 454、-3. 997、-5. 346、7. 212,P值均<0. 001),术后1周ALT、TBil、Alb变化较术前有明显差异(t值分别为-3. 177、-3. 665、3. 194,P值均<0. 05)。术后1个月1级和2级不良反应发生率为68. 6%(35/51),未出现肝衰竭、肝脓肿、胆汁瘤、消化道出血等并发症,1例患者术后61 d因肿瘤进展死于多脏器功能衰竭。结论超液态碘化油联合药物洗脱微球TACE治疗BCLC B/C期HCC是安全有效的,远期疗效及生存获益有待于进一步观察。
Objective To investigate the clinical effect and safety of transarterial chemoembolization( TACE) with ultra-liquid iodized oil combined with drug-eluting beads in the treatment of Barcelona Clinic Liver Cancer( BCLC) stage B/C hepatocellular carcinoma( HCC).Methods A retrospective analysis was performed for the clinical data of 51 patients with BCLC stage B/C HCC who underwent TACE with ultra-liquid iodized oil combined with drug-eluting beads in The First Affiliated Hospital of Soochow University from May 2016 to September 2018. Liver function was observed before treatment and at 3 days,7 days,and 1 month after treatment,and adverse events and complications were recorded in detail. Modified Response Evaluation Criteria in Solid Tumors was used to evaluate clinical outcome at 1 and 3 months after surgery. The t-test was used for comparison of continuous data between two groups. Results Superselective TACE procedure was completed in all 51 patients. At 1 month after surgery,the target lesions had a disease remission rate of 70. 6% and a disease control rate of 96. 1%,while at 3 months after surgery,the target lesions had a disease remission rate of 64. 0% and a disease control rate of88. 0%. Of all 51 patients,5( 9. 8%) experienced acute liver injury at 3 days after surgery,and there were significant changes in alanine aminotransferase( ALT),aspartate aminotransferase,total bilirubin( TBil),and albumin( Alb)( t =-5. 454,-3. 997,-5. 346,and7. 212,all P < 0. 001). There were also significant changes in ALT,TBil,and Alb at 7 days after surgery( t =-3. 177,-3. 665,and3. 194,all P < 0. 05). Of all 51 patients,35( 68. 6%) experienced grade 1 or 2 adverse events at 1 month after surgery,and no complications of liver failure,liver abscess,bile tumor,and gastrointestinal bleeding were observed. One patient died of multiple organ failure due to tumor progression on day 61 after surgery. Conclusion TACE with ultra-liquid iodized oil combined with drug-eluting beads is safe and effective in the treatment of BCLC stage B/C HCC,and further studies are needed to observe long-term efficacy and survival benefit.
作者
唐浩桓
朱晓黎
王万胜
李婉慈
周林峰
杜航
TANG Haohuan;ZHU Xiaoli;WANG Wansheng(Department of Interventional Radiology,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215006,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2019年第7期1509-1513,共5页
Journal of Clinical Hepatology
基金
江苏省第五期“333高层次人才培养工程”科研项目BRA2017566)
国家自然科学基金面上项目(81771945)
江苏省科教兴卫工程医学重点人才课题(ZDRCA2016038)
关键词
癌
肝细胞
碘化油
微球体
化学栓塞
治疗性
carcinoma,hepatocellular
iodized oil
microspheres
chemoembolization,therapeutic
