表柔比星药物洗脱微球肝动脉化疗栓塞术治疗不可手术切除的原发性肝癌患者临床疗效和安全性分析

doi:10.3969/j.issn.1672-5069.2022.02.027

摘要/Abstract

摘要： 目的探讨采用表柔比星药物洗脱微球肝动脉化疗栓塞术(DEB-TACE)治疗不可手术切除的原发性肝癌(PLC)患者的临床疗效和安全性。方法 2016年1月～2019年6月我院收治的78例不可手术切除是PLC患者,其中接受TACE治疗42例,接受表柔比星DEB-TACE治疗36例。根据RECIST评估临床疗效,比较两组治疗相关不良事件。随访2年,采用Log-Rank检验比较生存率。结果 DEB-TACE治疗组完全缓解(CR)、部分缓解(PR)、稳定(SD)和疾病进展(PD)率分别为16.7%、66.7%、13.9%和2.8%,客观缓解(OR)率为83.3%,而TACE治疗组分别为2.4%、52.4%、33.3%和11.9%,OR率为54.8%,差异显著(P<0.05);术后,DEB-TACE治疗组1级和2级腹痛分别为11.1%和33.3%,与TACE治疗组的30.9%和14.3%比,差异显著(P<0.05),1级恶心呕吐发生率为27.8%,显著高于TACE治疗组的9.5%,差异显著(P<0.05);在治疗结束后随访2年,TACE组和DEB-TACE组1 a生存率分别为71.4%和80.5%,差异无统计学意义(P>0.05),2 a生存率分别为42.9%和69.4%,差异有统计学意义(P<0.05)。结论采用DEB-TACE治疗不可手术切除的PLC患者疗效确切,可能是提高了局部药物浓度,临床预后优于常规TACE治疗患者,而与治疗相关的不良事件并未显著增加。

关键词: 原发性肝癌, 药物洗脱微球肝动脉化疗栓塞术, 治疗, 生存率

Abstract: Objective The aim of this study was to investigate the efficacy and safety of epirubicin drug-eluting beads-transcatheter arterial chemoembolization (DEB-TACE) in the treatment of patients with unresectable primary liver cancer (PLC). Methods 78 patients with unresectable PLC were enrolled in our hospital between January 2016 and June 2019, and 42 patients received TACE and 36 patients underwent epirubicin DEB-TACE. The clinical efficacy was evaluated based on RECIST 3 months after treatment and the treatment-related adverse events were recorded. All patients were followed-up for two years, and the survival rate was compared by Log-Rank test. Results The complete remission (CR), partial remission (PR), stable disease (SD) and progressive disease (PD) in DEB-TAC-treated patients were 16.7%, 66.7%, 13.9% and 2.8% with the objective remission (OR) rate of 83.3%, significantly different compared to 2.4%, 52.4%, 33.3% and 11.9% with OR of 54.8% in TACE-treated patients (P<0.05); after treatment, the grade one and grade two abdominal pain in DEB-TACE-treated patients were 11.1% and 33.3%, significantly different compared to 30.9% and 14.3% in TACE-treated patients (P<0.05), and grade one nausea and vomiting was 27.8%, significantly higher than 9.5% in patients receiving TACE treatment (P<0.05); at the end of two-year follow-up, the 1 year survival rates in TACE-treated and DEB-TACE-treated patients were 71.4% and 80.5% (P>0.05), while the 2 year survival rates were 42.9% and 69.4%, significantly different (P<0.05). Conclusion DEB-TACE is efficacious in the treatment of patients with unresectab PLC without increased side effect, which might be related to the increased local drug concentration.

Key words: Hepatoma, Drug-eluting beads-transcatheter arterial chemoembolization, Therapy, Survival

王婵, 沈长清, 吴晓琼, 邓程伟, 谢文蕊. 表柔比星药物洗脱微球肝动脉化疗栓塞术治疗不可手术切除的原发性肝癌患者临床疗效和安全性分析[J]. 实用肝脏病杂志, 2022, 25(2): 259-262.

Wang Chan, Shen Changqing, Wu Xiaoqiong, et al. Efficacy and safety of epirubicin drug-eluting beads-transcatheter arterial chemoembolization in the treatment of patients with unresectable primary liver cancer[J]. Journal of Practical Hepatology, 2022, 25(2): 259-262.

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