CalliSpheres载药微球与碘化油栓塞治疗肝转移瘤的近期疗效与安全性对比分析

CalliSpheres drug-loaded microspheres embolization versus iodized oil embolization for the treatment of hepatic metastases: a comparative study of short-term efficacy and safety

目的对比分析CalliSpheres载药微球与碘化油栓塞治疗肝转移瘤的近期疗效及安全性。方法回顾性分析2016年1月—2018年12月连续收治的肝转移瘤患者51例,共213个病灶。根据患者所使用栓塞材料分为碘化油组(29例)和微球组(22例),两组患者分别使用碘化油配伍+盐酸吡柔比星、CalliSpheres微球负载盐酸吡柔比星行TACE治疗,所有患者在栓塞之前均使用奥沙利铂及雷替曲塞行肝动脉化疗灌注。比较分析两组治疗的近期疗效及安全性。结果两组患者行TACE术后,根据改良实体瘤疗效评价(mRECIST)标准评估患者近期疗效,微球组的总缓解率(CR+PR)及获益率(CR+PR+SD)分别为59.1%、90.9%,高于碘化油组的31.0%、65.5%,差异有统计学意义(P<0.05)。两组患者术后栓塞后综合征发生情况比较,差异无统计学意义(P>0.05)。两组患者治疗前后肝功能变化差值对比,差异无统计学意义(P>0.05)。6个月内微球组行TACE次数少于碘化油组(P<0.05)。结论 CalliSpheres载药微球栓塞治疗肝转移瘤的近期疗效优于碘化油,安全性与碘化油栓塞TACE相仿,临床上可推广应用。

Objective To compare the short-term efficacy and safety of CalliSpheres drug-loaded microspheres embolization with those of iodized oil embolization in the treatment of hepatic metastases.Methods The clinical data of a total of 51 consecutive patients with hepatic metastases(213 lesions in total),who were admitted to the Affiliated Hospital of Xuzhou Medical University of China during the period from January 2016 to December 2018, were retrospectively analyzed. According to the embolization materials used in treatment, the patients were divided into iodized oil group(n=29) and microsphere group(n=22). Transcatheter arterial chemoembolization(TACE) by using iodized oil plus pirarubicin hydrochloride was performed for the patients of iodized oil group, while TACE by using microspheres loaded with pirarubicin hydrochloride was adopted for the patients of microsphere group. Pre-embolization hepatic artery chemotherapy with perfusion of oxaliplatin and retitreflex was employed in all patients of both groups. The short-term efficacy and safety were compared between the two groups. Results The mRECIST evaluation criteria was used to assess the short-term efficacy. The overall remission rate(CR+PR) and the benefit rate(CR+PR+SD) in the microsphere group were 59.1% and 90.9% respectively, which were higher than 31.0% and 65.5% respectively in the iodized oil group, the differences between the two groups were statistically significant(P<0.05). No statistically significant difference in the incidence of post-embolization syndrome existed between the two groups(P>0.05). There were no statistically significant differences in liver function indexes between preoperative values and postoperative ones(P>0.05). The number of TACE times performed within 6 months in the microsphere group was remarkably less than that in the iodized oil group(P<0.05). Conclusion For the treatment of hepatic metastases, the short-term efficacy of CalliSpheres drug-loaded microspheres embolization is better than that of iodized oil embolization, while its safety is similar to that of iodized oil embolization. Therefore, Calli Spheres drug-loaded microspheres embolization should be popularized in clinical practice.