载药微球化疗栓塞治疗不可切除软组织肉瘤初步疗效分析

Drug-eluting bead transcatheter arterial chemoembolization for the treatment of unresectable soft tissue sarcoma: preliminary analysis of its curative effect

目的探讨载药微球化疗栓塞(DEB-TACE)治疗软组织肉瘤的初步疗效及安全性、可行性。方法回顾性分析2017年4月至2019年4月接受DEB-TACE治疗的12例软组织肉瘤患者(病灶数24个)的临床资料,术前均经病理学确诊。根据介入术后1、3、6和12个月CT/MRI,评价其疗效。记录无进展生存期(PFS)和总生存期(OS)。观察有无严重不良事件(AE)。结果12例患者DEB-TACE手术28例次均顺利,有不同程度的术后反应,以疼痛为主(10/12,83.3%),对症治疗后均好转。中位随访时间14.5个月(4~23个月)。疗效评价:术后1、3、6和12个月总客观有效率(ORR)分别为75.0%(9/12)、75.0%(9/12)、66.7%(8/12)、58.3%(7/12),6、12个月OS率和PFS率分别为91.7%和66.7%、83.3%和58.3%,中位PFS为11.5个月(3~23个月);术后1、3、6和12个月局部肿瘤的ORR分别为79.2%(19/24)、83.3%(20/24)、78.3%(18/23)、72.7%(16/22),局部肿瘤中位PFS为17.5个月(3~23个月)。结论DEB-TACE治疗软组织肉瘤近期疗效确切,技术安全可行。

Objective To make a preliminary discussion on the safety and feasibility of drug-eluting bead transcatheter arterial chemoembolization(DEB-TACE) in the treatment of soft tissue sarcoma. Methods The clinical data of 12 patients with soft tissue sarcoma, who received DEB-TACE during the period from April 2017 to April 2019 at authors’ hospital, were retrospectively analyzed. The diagnosis was confirmed by preoperative pathological examination in all patients. The curative effect was evaluated by CT/MRI performed at 1, 3, 6 and 12 months after DEB-TACE. The progression-free survival(PFS) and overall survival(OS) were calculated. The serious adverse events(AEs) were recorded. Results A total of 28 DEB-TACE procedures were successfully carried out in the 12 patients. Different degrees of postoperative reactions were observed. The main postoperative response was pain(10/12, 83.3%), which were relieved after symptomatic treatment. The median follow-up period was 14.5 months(4-23 months). The postoperative 1-, 3-, 6-and 12-month total objective response rates(ORR) were 75.0%(9/12), 75.0%(9/12), 66.7%(8/12) and 58.3%(7/12) respectively.The postoperative 6-and 12-month OS were 91.7% and 83.3% respectively, and postoperative 6-and 12-month PFS were 66.7% and 58.3%, respectively. The median PFS was 11.5 months(3-23 months). A total of 24 lesions were detected in the 12 patients. The postoperative 1-, 3-, 6-and 12-month ORRs of local tumor were 79.2%(19/24), 83.3%(20/24), 78.3%(18/23) and 72.7%(16/22) respectively. The median PFS of local tumor lesions was 17.5 months(3-23 months). Conclusion For the treatment of soft tissue sarcoma, DEB-TACE has definite and reliable short-term efficacy, and the technique of DEB-TACE is clinically safe and feasible.(J Intervent Radiol, 2021, 30: 455-460)