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肝动脉化疗栓塞(tace)用于肝细胞癌的治疗:法国全国性现况调查的结果-ag捕鱼平台

文字: 2018-5-28    浏览次数:1009    

 

purpose: to report current practices oftransarterial chemoembolization (tace) by interventional radiologists (ir) forhepatocellular carcinoma (hcc) through a french national survey.

目的:为了报告肝动脉化疗栓塞用于肝细胞癌(hcc)治疗的现况,进行了一次针对法国全国介入放疗科医生的调查。


materialsand methods: anelectronic survey was sent by e-mail to 232 irs performing tace in 32 privateor public centers. the survey included 66 items including indications for tace,technical aspects of tace, other locally available treatments for hcc,follow-up imaging and general aspects of interventional radiology practices. 

材料和方法:通过电子邮件调查了232名来自法国32家私立或公立医院的、从事肝动脉化疗栓塞(tace)的介入放射科医生。调查问卷设置了66个条目,包括tace的适应症、tace的技术、肝细胞癌的其它局部治疗方法,影像学随访和介入放射学实践的常识问题。


results:a total of 64 irs (64/232; 27%) answered the survey. each ir performed a mean of49 ± 45 (sd) tace procedures per year. marked variations in indications for tace in hcc were observed. six percent of irs (4/64) treated only patients with barcelona clinic liver cancer (bclc) stage b hcc. antibioprophylaxis was notused by 43/64 of irs (67%). the number of hcc nodules was considered to select conventional tace versus drug-eluting beads tace (deb-tace) by 17/49 irs (35%)followed by patient performance status and child-pugh score by 6/49 irs (12%).seventy-three percent of irs (45/62) treated nodules selectively in patients with unilobar disease with ctace. thirty-three percent of irs (21/64) planned systematically a second tace session. doxorubicin was the most frequently used drug (52/64; 81%) and 15/64 irs (23%) used gelatine sponge as the only embolicagent. for deb-tace, 100-300 μm beads were used by 26/49 irs (53%) and noadditional embolization was performed by 19/48 irs (39%). monopolarradiofrequency technique was widely available (59/63; 94%) compared toselective internal radiation therapy (37/64; 58%). magnetic resonance imaging was used for follow-up by 13/63 irs (20%). 

结果:共有64名介入放射科医生(64/232; 27%) 回答了调查问卷。每位介入放射科医生每年平均进行49±45(sd)次tace。调查发现tace用于hcc治疗的适应症存在明显的差异。6%的介入放射科医生仅将tace用于bclc-b期的hcc患者。67%介入放射科医生(43/64)没有预防性使用抗生素。35%(17/49)的医生通过患者的hcc肿瘤结节数量来决定是选择c-tace还是deb-tace,而12%的医生则是通过患者的一般状态来选择(ps评分和child-push评分)。73%(45/62)的医生采用c-tace选择性地治疗仅单叶有肿瘤生长的肝癌患者。33%(21/64)的医生系统性地计划了第二次tace。多柔比星是最常用的药物(52/64;81%)23%(15/64)的医生采用明胶海绵作为唯一的栓塞材料。在行deb-tace时,53%(26/49)的医生选择100-300μm微球,39%(19/48)的医生不再进行额外栓塞。与选择性体内放射治疗相比(37/64;58%),单极射频技术(59/63;94%)得到了广泛运用。20%(13/63)的医生采用磁共振作为影像学随访手段。


conclusion:current practices of tace for hcc varied widely among irs suggesting a need for more standardized practices.

结论:介入放射科医生在将tace用于hcc患者治疗方面存在较大差异,这提示法国需要更多临床实践标准