CalliSpheres载药微球栓塞治疗消化系统恶性肿瘤肝转移的初步分析

Preliminary analysis of CalliSpheres drug-eluting bead embolization in treating hepatic metastases from malignant tumors of digestive system

目的探讨经导管CalliSpheres载药微球栓塞治疗消化系统恶性肿瘤肝转移的有效性及安全性。方法回顾性分析2017年11月—2018年11月收治的44例消化系统恶性肿瘤肝转移患者,按照治疗方案分为DEB-TACE(drug-eluting bead TACE)组18例,cTACE(conventional TACE)组26例。DEBTACE组予以CalliSpheres载药微球栓塞治疗,cTACE组予以碘油-化疗药物乳剂及补充的明胶海绵颗粒栓塞治疗。比较两组近期疗效、术后肝功能变化及不良反应发生情况。结果44例患者均成功接受TACE治疗,DEB-TACE组的客观缓解率及疾病控制率均高于cTACE组,差异有统计学意义(P<0.05)。术后1周,两组患者肝功能均出现一定程度的损伤,cTACE组损伤程度高于DEB-TACE组,差异有统计学意义(P<0.05)。术后1个月,肝功能基本恢复正常水平,两组差异无统计学意义(P>0.05)。所有患者术后均未出现胆道损伤、肿瘤破裂出血、肝脓肿及食管胃底静脉曲张破裂导致的消化道出血等严重并发症。结论CalliSpheres载药微球栓塞治疗消化系统恶性肿瘤肝转移短期疗效与安全性良好。

Objective To investigate the efficacy and safety of transcatheter CalliSpheres drug-eluting bead embolization in the treatment of hepatic metastases from malignant tumors of digestive system.Methods The clinical data of a total of 44 patients with hepatic metastases from digestive malignancies,who were admitted to authors’hospital during the period from November 2017 to November 2018 to receive transcatheter arterial chemoembolization(TACE),were enrolled in this study.According to treatment plan,the patients were divided into DEB-TACE group(receiving TACE with drug-eluting bead,n=18)and conventional TACE group(c TACE group,receiving TACE with iodized oil-chemotherapeutic drug emulsion and supplemented gelatin sponge particles,n=26).The short-term curative effect,postoperative hepatic functions and adverse reactions were compared between the two groups.Results Successful TACE treatment was accomplished in all 44 patients.The objective response rate and disease control rate of DEB-TACE group were higher than those of c TACE group,and the differences were statistically significant(P<0.05).One week after TACE,the hepatic function of both groups showed some degrees of damage,and the hepatic function damage of cTACE group was more severe than that of DEB-TACE group,the difference was statistically significant(P<0.05).One month after TACE,the hepatic function was basically returned to normal level,and the difference between the two groups was not statistically significant(P>0.05).No serious complications,such as biliary tract injury,tumor rupture with bleeding,hepatic abscess formation or gastrointestinal haemorrhage caused by rupture of esophageal and gastric fundus varices,occurred in all patients.Conclusion For the treatment of hepatic metastases from malignant tumors of digestive system,DEB-TACE has satisfactory short-term curative effect and safety.(J Intervent Radiol,2020,29:983-987)