载药微球在肝动脉化疗栓塞术中对原发性肝癌患者的疗效观察

Clinical efficacy of drug-loaded CalliSpheres transcatheter arterial chemoembolization in patients with primary hepatocarcinoma

目的:观察载药微球在肝动脉化疗栓塞术(D-TACE)与传统的肝动脉化疗栓塞术(C-TACE)在治疗原发性肝癌中的疗效对比。方法:回顾性分析2019年1月至2021年12月广西医科大学附属肿瘤医院收治的95例行D-TACE治疗的肝癌患者病历资料,根据载药栓塞微球的应用分为D-TACE组(观察组,44例)和C-TACE组(对照组,51例);治疗后3个月观察效果,通过检查丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、白蛋白(ALB)评价肝功能指标,甲胎蛋白(AFP)评价肝癌细胞活力,电解质钾(K)、钙(Ca)、镁(Mg),观察两组近期临床疗效及不良反应发生情况,并随访12个月。结果:两组治疗后AFP均低于治疗前,治疗后观察组的AFP显著低于对照组(P<0.01);观察组和对照组疾病控制率分别为88.63%和70.59%,组间差异均有统计学意义(P<0.05);两组并发症无统计学意义(P>0.05);观察组患者12个月的生存率高于对照组(P<0.05);Child-Pugh分级、肿瘤数目、AFP、载药微球应用与患者生存预后密切相关。结论:D-TACE在原发性肝癌的治疗中近期效果优于C-TACE,且安全性及预后良好。

Objective:To compare the efficacy between drug-loaded CalliSpheres transcatheter arterial chemoembolization(D-TACE)and the conventional transcatheter arterial chemoembolization(C-TACE)in patients with primary hepatocarcinoma.Methods:The medical records of 95 patients with liver cancer treated with DTACE from January 2019 to December 2021 in the Guangxi Medical University Cancer Hospital were retrospectively analyzed.According to the application of D-TACE,the patients were divided into D-TACE group(observation group,44 cases)and C-TACE group(control group,51 cases).The clinical efficacy was observed 3 months after treatment.The liver function indexes were evaluated by checking alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),albumin(ALB),alpha-fetoprotein(AFP),electrolyte potassium(K),calcium(Ca),magnesium(Mg),and liver cancer cell viability.The short-term clinical efficacy and adverse reactions of the two groups were observed and followed up for 12 months.Results:After treatment,AFP levels in both groups were lower than before treatment,and the level of AFP in the observation group was significantly lower than that in the control group after treatment(P<0.01).The disease control rates of observation group and control group were 88.63%and 70.59%,respectively,with statistically significant differences between the groups(P<0.05).There was no statistical significance in complications between the two groups(P>0.05).The 12-month survival rate of the observation group was higher than that of the control group(P<0.05).The grades of Child-Pugh,the number of tumors,the level of AFP,and the use of drug-loaded CalliSpheres were closely related to the prognosis of the patient’s overall survival.Conclusion:D-TACE has better short-term efficacy than CTACE in the treatment of primary hepatocarcinoma,and has good safety and prognosis.