恒瑞医疗 网址: www.hrmedical.com.cn

专业文献

callispheres®微球化疗栓塞与常规化疗栓塞治疗肝细胞癌短期疗效的比较:一项多中心回顾性研究-ag捕鱼平台

文字: 2020-2-29    浏览次数:415    

梁斌,向华,马聪,熊斌,马亦龙,赵昌,姚袁晖,张子曙,陈常勇,李海平,龙清云,周军,罗超,邱怀明,胡红耀,赵辉,周国锋,郑传胜

purpose
this study aimed to compare the efficacy and safety between transarterial chemoembolization (tace) with callispheres® microspheres (csm-tace) and conven- tional tace (ctace) in patients with hepatocellular carcinoma (hcc).

目的

比较callispheres®微球化疗栓塞(csm-tace)与常规tace(ctace)治疗肝细胞癌(hcc)患者的短期疗效和安全性。

 

patients and methods
three hundred and thirty-five hcc patients receiving csm-tace or ctace were consecutively enrolled in this multi-center, retrospective cohort study, and then divided into csm-tace group and ctace group accordingly. complete response (cr), objective response (orr) and disease control response (dcr) was assessed according to mrecist criteria at 1 month (m1), 3 months(m3) and 6 months(m6) after treatment. progression-free survival (pfs) and overall survival (os) were assessed. liver function indexes and adverse events (aes) were also evaluated.

患者与方法

本多中心回顾性研究共纳入335例hcc患者,分为csm-tace组和ctace组。根据mrecist标准评估治疗后1(m1)、3(m3)和6个月(m6)的完全反应率(crr)、客观反应率(orr)和疾病控制率(dcr),计算患者无进展生存期(pfs)和总生存期(os),并分析影响肿瘤反应和患者生存的因素。评估患者肝功能和不良事件(ae)。

 

results
cr at m3 (p=0.020) and orr at m1 (p<0.001), m3 (p<0.001) and m6 (p=0.017) after treatment were significantly higher in the csm-tace compared with ctace group. dcrs, pfs (25.3 months vs 24.2 months, p=0.503) and os (27.8 months vs 25.3 months, p=0.203) were similar between the two groups. csm-tace was independently correlated with higher orr at m1 (p=0.002) and longer os (p=0.023). abnormal alkaline phosphatase (alp) (p=0.049) was independently associated with lower orr at m3, and history of alcohol intake (p=0.019) and largest nodule size≥7 cm (p=0.015) independently correlated with lower orr at m6 (p=0.015). largest nodule size≥7 cm (p=0.029) and abnormal albumin (alb) (p=0.046) were independently associated with shorter pfs. child-pugh stage b/c (p=0.023), abnormal alb (p=0.001), alp (p=0.008) and alpha-fetoprotein (afp) (p=0.005) were independently associated with shorter os. most liver function indexes and aes were similar between the two groups (p>0.05), except that alp (p=0.005), total bilirubin (p=0.031), pain during procedure (p=0.034) and occurrence of fever post(treatment (p=0.017) were significantly elevated in the csm-tace compared with ctace group.

结果

csm-tace治疗组crr(m3,p = 0.020)、orr(m1,p <0.001;m3,p <0.001;m6,p = 0.017)显著性高于ctace组。两组间dcr,pfs(25.3个月vs.24.2个月,p = 0.503)和os(27.8个月vs 25.3个月,p = 0.203)无显著性差异。多因素分析显示csm-tace与更高的orr(m1,p = 0.002)和更长的os(p = 0.023)独立相关。然而,碱性磷酸酶(alp)与更低的orr独立相关(m3,p = 0.049);酒精摄入史(p = 0.019)和最大结节≥7cm(p = 0.015)与m6更低的orr独立相关;最大结节≥7cm(p = 0.029)和白蛋白异常(alb)(p = 0.046)与更短的pfs独立相关;child-pugh b/c期(p = 0.023),alb(p = 0.001),alp(p = 0.008)和甲胎蛋白(afp)(p = 0.005)与更短的os独立相关。安全性方面,csm-tace组术中疼痛(p = 0.034)、术后发热(p = 0.017)、alp(p = 0.005)和总胆红素(p = 0.031)显著性高于ctace组,两组间其他肝功能指标和ae相似。

 

conclusions
csm-tace presents with a better treatment response and similar survival profile compared with ctace in hcc patients.

结论

六个月的近期结果提示,与ctace相比,csm-tace治疗hcc具有更好的治疗反应和相似的生存期。