温度敏感型栓塞剂经肝动脉化疗栓塞术治疗肝细胞癌的疗效及安全性分析

Efficacy and safety of thermosensitive embolic material-transarterialchemoembolization for the treatment of hepatocellular carcinoma

目的 评价温敏型栓塞剂经肝动脉化疗栓塞术(TEM-TACE)治疗中晚期肝癌的疗效及安全性。方法 选取2020年12月—2023年8月于徐州医科大学附属徐州市立医院行TEM-TACE或传统经肝动脉化疗栓塞术(C-TACE)治疗的中晚期肝癌患者40例,收集临床资料进行回顾性分析。根据使用的栓塞材料不同,将患者分为TEM-TACE组和C-TACE组,每组20例。比较2组患者的临床疗效、生存期、肝功能变化及栓塞后综合征的发生情况。结果 TEM-TACE组接受1~2次介入治疗的患者显著于C-TACE组(P=0.025)。治疗1、3、6个月后TEM-TACE组患者的客观缓解率(ORR)分别为65%、60%、50%,疾病控制率(DCR)分别为80%、75%、70%,而C-TACE组的ORR分别为75%、75%、55%,DCR分别为85%、80%、80%,差异均无统计学意义(P>0.05)。TME-TACE组患者的中位无进展生存期为8.1个月(95%CI:6.9~9.3个月),中位总生存期为14.2个月(95%CI:11.5~16.7个月),而C-TACE组则分别为8.2个月(95%CI:5.4~11.0个月)和12.5个月(95%CI:10.3~14.7个月),2组相比差异均无统计学意义(P>0.05)。C-TACE组患者术后3个月的谷草转氨酶及总胆红素较TEM-TACE组显著升高,差异有统计学意义(P<0.05)。2组患者术后栓塞综合征的发生率比较,差异无统计学学意义(P>0.05)。结论 TEM-TACE治疗中晚期肝癌具有良好的疗效及安全性。

Objective To evaluate the efficacy and safety of thermosensitive embolic material-transarterial chemoembolization(TEM-TACE)in the treatment of moderate and advanced hepatocellular carcinoma.Methods A total of 40 patients with moderate and advanced hepatocellular carcinoma who underwent either TEM-TACE or conventional transarterial chemoembolization(C-TACE)at Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from December 2020 to August 2023 were enrolled.Their clinical data were collected for retrospective analysis.According to the type of embolic material used,the patients were divided into two groups(n=20):a TEM-TACE group and a C-TACE group.Both groups were compared for clinical efficacy,survival rates,changes in liver function,and the incidence of post-embolization syndrome.Results The number of TACE treatments was lower in the TEM-TACE group than in the C-TACE group,and there were no statistically significant differences in other baseline characteristics between the two groups The number of patients in the TEM-TACE group who received intervention treatment once or twice was higher than that in the C-TACE group(P>0.05).At post-treatment 1 month,3 months,and 6 months,the objective response rates(ORR)in the TEM-TACE group were 65%,60%,and 50%,respectively,and the disease control rates(DCR)were 80%,75%,and 70%,respectively.In the C-TACE group,the ORRs were 75%,75%,and 55%,and the DCRs were 85%,80%,and 80%,respectively;these differences were not statistically significant(P>0.05).The median progression-free survival(mPFS)in the TEM-TACE group was 8.1 months(95%CI:6.9-9.3 months),and the median overall survival(mOS)was 14.2 months(95%CI:11.5-16.7 months).In the C-TACE group,the mPFS and mOS were 8.2 months(95%CI:5.4-11.0 months)and 12.5 months(95%CI:10.3-14.7 months),respectively.At post-treatment 3 months,the levels of aspartate aminotransferase and total bilirubin were significantly higher in the C-TACE group than in the TEM-TACE group,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of post-embolization syndrome between the two groups(P>0.05).Conclusions TEM-TACE demonstrates good efficacy and safety in the treatment of moderate and advanced hepatocellular carcinoma.