DEB-TACE联合C-TACE治疗巨块型肝癌的近期疗效及安全性研究

A study on the short-term efficacy and safety of DEB-TACE combined with C-TACE in treatment of huge hepatocellular carcinoma

目的探讨经动脉载药微球化疗栓塞(DEB-TACE)联合常规经动脉化疗栓塞(C-TACE)治疗巨块型肝癌的近期疗效及安全性。方法回顾性分析2017年8月至2020年9月于桂林医学院附属医院和广西医科大学附属肿瘤医院接受介入治疗的44例巨块型肝癌患者的临床资料,其中27例采用DEB-TACE联合C-TACE治疗作为观察组,17例采用单独DEB-TACE治疗作为对照组。采用改良实体瘤疗效评价标准(mRECIST)对两组患者的近期疗效进行评价。比较两组手术前后生化指标变化情况及术后不良反应发生情况。结果两组术后1个月和3个月疾病客观缓解率(ORR)和疾病控制率(DCR)比较差异无统计学意义(P>0.05)。两组术后总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、凝血酶原时间(PT)、白细胞(WBC)、血尿素氮(BUN)水平均呈先上升后下降的趋势,血小板(PLT)水平呈先下降后上升的趋势,甲胎蛋白(AFP)、白蛋白(ALB)、血红蛋白(Hb)、肌酐(CREA)水平呈下降趋势,两组各指标变化幅度比较差异无统计学意义(P>0.05)。两组发热、腹痛、恶心呕吐、便秘及骨髓抑制等不良反应发生率比较差异无统计学意义(P>0.05)。结论DEB-TACE联合C-TACE治疗巨块型肝癌的近期疗效不优于单纯DEB-TACE。

Objective To explore the short-term efficacy and safety of drug-eluting bead transarterial chemoembolization(DEB-TACE)combined with conventional transarterial chemoembolization(C-TACE)in treatment of huge hepatocellular carcinoma.Methods The clinical data of 44 patients with huge hepatocellular carcinoma who received interventional therapy in Affiliated Hospital of Guilin Medical University and Guangxi Medical University Cancer Hospital from August 2017 to September 2020 were retrospectively analyzed.Among them,27 patients receiving DEB-TACE combined with C-TACE treatment were selected as observation group,and 17 patients receiving DEB-TACE treatment alone were selected as control group.Modified Response Evaluation Criteria in Solid Tumors(mRECIST)were used to evaluate the short-term efficacy of the patients in the two groups.The changes of biochemical indicators before and after operation and the occurrence of postoperative adverse reactions were compared between the two groups.Results There were no significant differences in objective response rate(ORR)and disease control rate(DCR)between the two groups 1 month and 3 months after surgery(P>0.05).The levels of total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),prothrombin time(PT),white blood cell(WBC)and blood urea nitrogen(BUN)in both groups showed a trend of first increasing and then decreasing after operation,while the level of platelet(PLT)showed a trend of first decreasing and then increasing,and the levels of alpha fetoprotein(AFP),albumin(ALB),hemoglobin(Hb)and creatinine(CREA)showed a downward trend,and there was no statistically significant difference in the changing amplitude of each indicator between the two groups(P>0.05).There were no statistically significant differences in the incidence rates of adverse reactions such as fever,abdominal pain,nausea and vomiting,constipation and bone marrow suppression between the two groups(P>0.05).Conclusion The short-term efficacy of DEB-TACE combined with C-TACE in treatment of huge hepatocellular carcinoma is not superior to that of DEB-TACE alone.