Embosphere微球与明胶海绵颗粒在无法手术切除的肝细胞性肝癌介入治疗中的临床对照研究

Clinical study of Embosphere microspheres and gelatin sponge particles used in transcatheter arterial chemoembolization for the treatment of unresectable hepatocellular carcinoma

目的比较分析Embosphere微球与明胶海绵颗粒在无法手术切除的肝细胞性肝癌(HCC)介入治疗中的应用效果。方法回顾性分析惠州市中心人民医院自2013年1月至2016年6月收治的92例行介入治疗的不可切除的HCC患者临床资料,按照术中使用的栓塞材料不同分为两组,微球(Embosphere microspheres)组42例,栓塞材料为碘油+Embosphere微球;明胶海绵颗粒组50例,栓塞材料为碘油+明胶海绵颗粒。比较分析两组的住院费用、住院时间、术后毒副作用发生率、总缓解率、疾病控制率以及1年、2年生存率等指标差异。结果微球组肝区疼痛发生率(54.76%)、肝功能损害发生率(42.85%)显著低于明胶海绵组(78.00%,66.00%),差异有统计学意义(P<0.05);微球组肿瘤进展率(4.76%)低于明胶海绵组(20.00%),疾病控制率(95.24%)高于明胶海绵组(80.00%),差异有统计学意义(P<0.05)。结论本研究显示Embosphere微球可安全有效地应用于无法手术切除的HCC的介入治疗,在毒副作用发生率、疾病控制率方面较明胶海绵颗粒具有优势,但需要多中心、大样本、前瞻性随机对照研究进一步评估其临床应用效果。

Objective To compare the efficacy of Embosphere microspheres and gelatin sponge particles in transcatheter arterial chemoembolization（TACE） for the treatment of unresectable hepatocellular carcinoma（HCC）.Methods The clinical data of 92 HCC patients treated with TACE from Jan.2013 to Jun.2016 in Huizhou Municipal Central Hospital was retrospectively analyzed.According to different embolic agents used in TACE procedure,92 patients were divided into two groups：Embosphere microspheres group with 42 patients and Gelatin sponge particles group with 50 patients.Several comparative indexes including hospital charges,hospitalization duration,rate of toxic adverse effects,overall response rate（ORR）,disease control rate（DCR）,1-and 2-year survival rates were compared in two groups.Results The rates of abdominal pain and liver function damage in Embosphere microspheres group were significantly lower than those in Gelatin sponge particles group（54.76% vs 78.00% and 42.85% vs 66.00%,P〈0.05,respectively）.The progression rate in Embosphere microspheres group was significantly lower than that in Gelatin sponge particles group（4.76% vs 20.00%;P〈0.05）.And the disease control rate（DCR） in Embosphere microspheres group was significantly higher than that in Gelatin sponge particles group（95.24% vs 80.00%;P〈0.05）.Conclusion Embosphere microspheres can be used in TACE treatment for unresectable HCC safely and effectively,which has advantages over gelatin sponge particles in the rates of toxic adverse effects and disease control.But multi-center prospective randomized controlled trial with large sample is still needed to evaluate its clinical application.