中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

Efficacy and safety of microsphere transarterid chemoembolization combined with radiotherapy versus microsphere transarterial chemoembolization alone in treatment of patients with unresectable liver cancer

DOI: 10.3969/j.issn.1001-5256.2019.11.020
Research funding:

 

  • Received Date: 2019-06-19
  • Published Date: 2019-11-20
  • Objective To investigate the efficacy and safety of microsphere transarterial chemoembolization( TACE) combined with radiotherapy in the treatment of patients with unresectable liver cancer. Methods A total of 68 patients with unresectable liver cancer were enrolled in Shantou central hospital from January 2016 to October 2018,among whom there were 65 male and 3 female patients,with a median age of 55 years( range 36-75 years). These patients were randomly divided into microsphere TACE group with 34 patients and microsphere TACE combined with radiotherapy group( combined group with 34 patients). The two groups were compared in terms of short-term response rate,progression-free survival( PFS) rate,overall survival( OS) rate,and adverse events to evaluate safety. The chi-square test was used for comparison of categorical data between groups,and the Kaplan-Meier method and the log-rank test were used for comparison of PFS and OS rates. Results Up to the last follow-up on April 30,2019,all patients completed treatment as planned and the median follow-up time was 15. 2 months. A total of 25 deaths were observed. The objective response rate was 50. 0% in the microsphere TACE group and 76. 5% in the combined group,and the combined group had a significantly better short-term response than the microsphere TACE group( χ2= 7. 995,P = 0. 046). For the microsphere TACE group,the 6-,12-,18-,and 24-month OS and PFS rates were 94. 1%/76. 5%,69. 0%/47. 1%,51. 3%/23. 9%,and 30. 9%/9. 6%,respectively,and for the combined group,the 6-,12-,18-,and 24-month OS and PFS rates were 100%/93. 7%,87. 8%/81. 1%,75. 1%/52. 9%,and 58. 2%/44. 1%,respectively; the combined group had significantly better PFS and OS time than the microsphere TACE group( χ2= 9. 027 and 4. 288,P = 0. 002 7 and 0. 038). There was a low incidence rate of adverse events in the two groups,and no treatment-related death was observed. Conclusion Compared with microsphere TACE alone,microsphere TACE combined with radiotherapy significantly improves short-term response and long-term survival in patients with unresectable liver cancer and thus provides a more effective and safer treatment for such patients.

     

  • [1] TORRE LA,BRAY F,SIEGEL RL,et al. Global cancer statistics,2012[J]. CA Cancer J Clin,2015,65(2):87-108.
    [2] Chinese Expert Consensus Statement Chinese Society of Liver Cancer(CSLC), Chinese Society of Clinical Oncology(CSCO),Liver Cancer Group,Chinese Society of Hepatology.Consensus on standardized diagnosis and treatment of primary liver cancer[J]. J Clin Hepatol,2009,25(2):83-92.(in Chinese)中国抗癌协会肝癌专业委员会,中国抗癌协会临床肿瘤学协作专业委员会,中华医学会肝病学分会肝癌学组.原发性肝癌规范化诊治的专家共识[J].临床肝胆病杂志,2009,25(2):83-92.
    [3] BETTINGER D,GKIKA E,SCHULTHEISS M,et al. Comparison of local tumor control in patients with HCC treated with SBRT or TACE:A propensity score analysis[J]. BMC Cancer,2018,18(1):807.
    [4] WANG H,PAN YG,XIA JT,et al. Clinical effect of transcatheter arterial chemoembolization in treatment of primary liver cancer:Application and research advances[J]. J Clin Hepatol,2018,34(2):414-418.(in Chinese)王辉,潘裕国,夏金堂,等.经肝动脉化疗栓塞术在原发性肝癌治疗中的应用[J].临床肝胆病杂志,2018,34(2):414-418.
    [5] CHIANG CL,CHAN MKH,YEUNG CSY,et al. Combined stereotactic body radiotherapy and trans-arterial chemoembolization as initial treatment in BCLC stage B-C hepatocellular carcinoma[J]. Strahlenther Onkol,2019,195(3):254-264.
    [6] WANG HY. Clinical effect of Embosphere microsphere in transarterial chemoembolization for liver cancer[D]. Qingdao:Qingdao University,2017.(in Chinese)王洪雨.Embosphere微球在肝癌TACE治疗中的临床疗效分析[D].青岛:青岛大学,2017.
    [7] WU BL,ZHOU J,LING GH,et al. Efficacy and safety analysis of 8Spheres microspheres combined with lipiodol TACE in the treatment of hepatocellular carcinoma[J]. Med J Wuhan Univ,2018,39(2):248-252.(in Chinese)吴宝林,周军,凌公豪,等.8Spheres微球联合碘油TACE治疗原发性肝癌的疗效及安全性[J].武汉大学学报:医学版,2018,39(2):248-252.
    [8] National Health and Family Planning Commission of the People's Republic of China. Diagnosis,management,and treatment of hepatocellular carcinoma(V2017)[J]. J Clin Hepatol,2017,33(8):1419-1431.(in Chinese)中华人民共和国国家卫生和计划生育委员会.原发性肝癌诊疗规范(2017年版)[J].临床肝胆病杂志,2017,33(8):1419-1431.
    [9] Chinese College of Interventionalists,Chinese Med. Chinese Clinical Practice Guidelines for transarterial chemoembolization of hepatocellular carcinoma[J]. Chin J Radiol,2019,54(3):246-255.(in Chinese)中国医师协会介入医师分会.中国肝细胞癌经动脉化疗栓塞治疗(TACE)临床实践指南[J].中华放射学杂志,2019,54(3):246-255.
    [10] SEYAL AR,GONZALEZ-GUINDALINI FD,ARSLANOGLU A,et al. Reproducibility of m RECIST in assessing response to transarterial radioembolization therapy in hepatocellular carcinoma[J]. Hepatology,2015,62(4):1111-1121.
    [11] CHEN LC,CHIOU WY,LIN HY,et al. Comparing stereotactic ablative radiotherapy(SABR)versus re-trans-catheter arterial chemoembolization(re-TACE)for hepatocellular carcinoma patients who had incomplete response after initial TACE(TASABR):A randomized controlled trial[J]. BMC Cancer,2019,19(1):275.
    [12] LIU LB,WANG JF,CHENG GH,et al. Explanation of diagnostic criteria for radiation-induced liver diseases[J]. Int J Radiat Med Nuclear Med,2012,36(4):252-255.(in Chinese)刘丽波,王剑峰,程光惠,等.《放射性肝病诊断标准》解读[J].国际放射医学核医学杂志,2012,36(4):252-255.
    [13] LI SY,WU S,CHEN TS,et al. Effect of portal venous perfusion cinobufacini injection combined with TACE in patients with intermediate hepatocellular carcinoma[J]. Clin J Med Offic,2017,45(9):884-886.(in Chinese)李淑英,吴申,陈挺松,等.经导管肝动脉栓塞化疗联合华蟾素门静脉灌注治疗中期原发性肝癌疗效研究[J].临床军医杂志,2017,45(9):884-846.
    [14] KOTHARY N,WEINTRAUB JL,SUSMAN J,et al. Transarterial chemoembolization for primary hepatocellular carcinoma in patients at high risk[J]. J Vasc Interv Radiol,2007,18(12):1517-1526; quiz 1527.
    [15] ZHU LL,CAI CF,MENG Y. Therapeutic efficiency of transcatheter arterial chemoembolization combined with intensity modulated radiation therapy against un-resectable primary hepatocellular carcinoma[J]. Int J Med Radiol,2019,42(2):149-153.(in Chinese)朱六玲,蔡陈枫,孟岩.TACE联合调强放疗对不可切除原发性肝癌的疗效研究[J].国际医学放射学杂志,2019,42(2):149-153.
    [16] MA M,NIU TT,SHAO L,et al. Hepatic transcatheter arterial chemoembolization combined with stereotactic radia-tion therapy of primary liver cancer[J]. Trauma and Crit Medicine,2017,5(1):32-35.(in Chinese)马明,牛婷婷,邵亮,等.肝动脉化疗栓塞术联合立体定向放疗治疗较大原发性肝癌临床研究[J].创伤与急危重病医学,2017,5(1):32-35.
    [17] LENG ZQ,LIANG ZY,SHI S. Clinical effect of interventional treatment,radiotherapy,and multimodality therapy for liver cancer[J]. Chin J Radiat Oncol,2000,9(2):99.(in Chinese)冷祝强,梁赵玉,石珊.肝癌介入治疗放射治疗及综合治疗的疗效分析[J].中华放射肿瘤学杂志,2000,9(2):99.
    [18] SEONG J,PARK HC,HAN KH,et al. Clinical results and prognostic factors in radiotherapy for unresectable hepatocellular carcinoma:A retrospective study of 158 patients[J]. Int J Radiat Oncol Biol Phys,2003,55(2):329-336.
    [19] ZHANG YW,ZHANG Y,LING ZH,et al. Clinical effect of threedimensional conformal radiotherapy combined with transarterial chemoembolization versus transarterial chemoembolization alone in treatment of liver cancer:A meta-analysis[J]. J South Med Univ,2009,29(12):2514-2516.(in Chinese)张耀伟,张勇,凌志海,等.三维适形放疗联合TACE与单纯TACE治疗肝癌疗效的meta分析[J].南方医科大学学报,2009,29(12):2514-2516.
    [20] LUO JJ,YAN ZP,WANG JH,et al. HCC embolized by microspheres and iodized oil compared with by iodized oil alone[J]. Chin Comput Med Imag,2008,14(2):154-159.(in Chinese)罗剑钧,颜志平,王建华,等.微球+碘化油联合栓塞与碘化油单独栓塞治疗肝癌的比较研究[J].中国医学计算机成像杂志,2008,14(2):154-159.
    [21] ZHANG JX,LI FZ,CHAI J,et al. Clinical and controlled trial of transcatheter arterial chemoembolization with polyvinyl alcohol particle in patients with advanced hepatocellular carcinoma[J]. J Hepatopancreatobiliary Surg,2014,26(3):195-197,203.(in Chinese)张军喜,李发中,柴健,等.微球加碘化油栓塞治疗肝癌疗效的临床对照研究[J].肝胆胰外科杂志,2014,26(3):195-197,203.
    [22] XU YZ,DING YM,YANG Y. Combining chemoembolization using microspheres with iodized oil in the treatment of hepatocellular carcinoma:A Meta-analysis of randomized controlled trials[J]. Chin J Hepatobiliary Surg,2014,20(1):24-28.(in Chinese)徐彦哲,丁佑铭,杨阳.微球联合碘化油栓塞化疗治疗肝细胞癌的Meta分析[J].中华肝胆外科杂志,2014,20(1):24-28.
    [23] CAO G,WEN F. Comparison of microspheres embolization with lipiodol embolization[J]. Chin J Interv Imaging Ther,2016,13(8):518-519.(in Chinese)曹广,温峰.微球栓塞与碘油栓塞的比较[J].中国介入影像与治疗学,2016,13(8):518-519.
  • Relative Articles

    [1]Teng ZHANG, Quan WANG, Wengang LI, Xuezhang DUAN. Efficacy of stereotactic body radiotherapy combined with sintilimab and bevacizumab in treatment of unresectable hepatocellular carcinoma[J]. Journal of Clinical Hepatology, 2025, 41(1): 69-74. doi: 10.12449/JCH250111
    [2]Gang REN, Yingjie WANG. Advances in radiotherapy for pancreatic cancer from 2019 to 2020[J]. Journal of Clinical Hepatology, 2021, 37(3): 733-736. doi: 10.3969/j.issn.1001-5256.2021.03.048
    [3]Chinese Association for Therapeutic Radiation Oncologists, Chinese Society for Therapeutic Radiology and Oncology, Chinese Medical Association, Committee of Radiation Oncology, Chinese Anti-Cancer Association. Chinese radiotherapy guidelines for primary hepatocellular carcinoma (2020 edition)[J]. Journal of Clinical Hepatology, 2021, 37(5): 1029-1033. doi: 10.3760/cma.j.cn371439-20201208-00001
    [4]Precise Radiotherapy Study Group, Chinese Society of Liver Cancer, Chinese Medical Doctor Association, Liver Cancer Study Group, Committee of Radiation Oncology, Chinese Research Hospital Association, Committee of Tumor Radiobiology and Multimodal Imaging and Therapy, Chinese Research Hospital Association, Liver Cancer Study Group, Precise Radiotherapy Branch, Chinese Society of Biomedical Engineering. Consensus on radiation therapy for primary liver cancer (2020)[J]. Journal of Clinical Hepatology, 2021, 37(2): 296-301. doi: 10.3969/j.issn.1001-5256.2021.02.010
    [5]Ye ShengLong. Downstaging and conversion treatment of intermediate and advanced liver cancer should be taken seriously[J]. Journal of Clinical Hepatology, 2020, 36(2): 249-251. doi: 10.3969/j.issn.1001-5256.2020.02.001
    [6]Yuan ShengXian, Zhou WeiPing. Conversion therapy for hepatocellular carcinoma: Strategies and methods[J]. Journal of Clinical Hepatology, 2020, 36(2): 252-257. doi: 10.3969/j.issn.1001-5256.2020.02.002
    [7]Liu YueChen, Gu MengYu, Cheng Yu, Yang GuiYuan. An excerpt of radiation therapy for pancreatic cancer: Executive summary of an ASTRO clinical practice guideline (2019)[J]. Journal of Clinical Hepatology, 2020, 36(1): 50-52. doi: 10.3969/j.issn.1001-5256.2020.01.010
    [8]Li ShanShan, Chen Yu. Severe radiation-induced gastritis after radiotherapy for hepatocellular carcinoma: A case report[J]. Journal of Clinical Hepatology, 2019, 35(9): 2048-2049. doi: 10.3969/j.issn.1001-5256.2019.09.033
    [9]Wang Hui, Pan YuGuo, Xia JinTang, Zhou MiMi, Cai Chun. Clinical effect of transcatheter arterial chemoembolization in treatment of primary liver cancer: application and research advances[J]. Journal of Clinical Hepatology, 2018, 34(2): 414-418. doi: 10.3969/j.issn.1001-5256.2018.02.044
    [10]Wu Jian, Yin Fang, Luo GuanHong, Zheng YangYang, Li Hong, Zhu ShaoHua, Zhang Jing, Zhou XinMin. Clinical effect and safety of transarterial chemoembolization combined with apatinib in treatment of advanced primary liver cancer[J]. Journal of Clinical Hepatology, 2018, 34(4): 775-778. doi: 10.3969/j.issn.1001-5256.2018.04.016
    [11]Li TianTian, Sun Jing, Wang Quan, Ding JunQiang, Wang Jia, Xue Hui, Zhang Tao, Duan XueZhang. Clinical effect of stereotactic body radiotherapy in treatment of patients with small hepatocellular carcinoma and related prognostic factors[J]. Journal of Clinical Hepatology, 2018, 34(8): 1702-1706. doi: 10.3969/j.issn.1001-5256.2018.08.022
    [12]Wu YuNan, Zhang Dong, Sun KeWei. Clinical effect of Bielong Ruangan decoction combined with transcatheter arterial chemoembolization in treatment of hepatitis B virus-related primary liver cancer[J]. Journal of Clinical Hepatology, 2017, 33(11): 2152-2157. doi: 10.3969/j.issn.1001-5256.2017.11.020
    [13]Hu CaiXia, Zheng JiaSheng, Cui ShiChang, Qian ZhiLing. Efficacy of nutritional intervention in patients with primary hepatocellular carcinoma treated by transcatheter arterial chemoembolization[J]. Journal of Clinical Hepatology, 2015, 31(4): 569-572. doi: 10.3969/j.issn.1001-5256.2015.04.022
    [14]Liu Qi, Wu ZhenMing, Qi XiuHeng, Guo Qian. Survival analysis of intrahepatic arterial infusion of Endostar combined with transcatheter arterial chemoembolization for treatment of advanced hepatocellular carcinoma[J]. Journal of Clinical Hepatology, 2015, 31(2): 225-227. doi: 10.3969/j.issn.1001-5256.2015.02.019
    [15]Fang ZiYan, Huang Long, Li Gong. Research progress in radiotherapy for liver tumors reported in 2013 ASTRO Annual Meeting[J]. Journal of Clinical Hepatology, 2014, 30(4): 383-385. doi: 10.3969/j.issn.1001-5256.2014.04.025
    [16]Zhou ZhenDong, Zhang LeMing, Wang TingTing, Sun XiaoKe, Chen LiangLiang, Liu Kui. Meta-analysis of transarterial chemoembolization combined with microwave coagulation therapy in treatment of advanced liver cancer[J]. Journal of Clinical Hepatology, 2013, 29(8): 591-595. doi: 10.3969/j.issn.1001-5256.2013.08.010
    [17]Chen MinHua. Standardization of thermal ablation in treatment of liver tumor[J]. Journal of Clinical Hepatology, 2013, 29(8): 561-563. doi: 10.3969/j.issn.1001-5256.2013.08.001
    [18]Zhan GuoQing, Tan HuaBing, Zhu Lin, Li RuGui, Zhang WeiWei, Hu Bo, Du WeiXing. Antiviral effects of transcatheter hepatic arterial chemoembolization on middle and advanced stage hepatitis B virus-related liver cancer[J]. Journal of Clinical Hepatology, 2010, 26(4): 423-424+431.
    [19]Yang BiWei, Gan YuHong, Ye ShengLong, Zhang BoHeng, Ren ZhengGang, Xia JingLin, Wang YanHong, Ge NingLing, Chen Yi, Li LiXin, Le Fan, Zhang Lan. Necrosis range and safety of radiofrequency combined with systemic chemotherapy and radiofrequency alone.[J]. Journal of Clinical Hepatology, 2004, 20(6): 364-365.
    [20]Guo ZhanWen, Li Yu, Yan Ying, Tian QiHe, Xu Rui. Clinical study of 3-dimensional conformal radiotherapy on primary liver cancer.[J]. Journal of Clinical Hepatology, 2002, 18(3): 164-165.
  • Cited by

    Periodical cited type(13)

    1. 于宝秀. 循证支持下护理干预对肝动脉化疗联合微球栓塞术治疗原发性肝癌的有效性. 中国医药指南. 2023(02): 177-179 .
    2. 滕金豪,俞渊,刘春丽,肖丽,君杨文,庞浇安. MDT模式下中国原发性肝癌的外科治疗现状. 安徽医学. 2023(06): 736-740 .
    3. 刘迪,姚维杰,吴向阳,李楠,金栋. PD-1抑制药联合经肝动脉化疗栓塞术与酪氨酸激酶抑制药治疗不可切除肝细胞癌患者的临床研究. 中国临床药理学杂志. 2023(22): 3223-3227 .
    4. 刘志勇,周建伟,潘龙赐,葛婷,陈康海. 温阳扶正方联合肝动脉化疗栓塞术治疗脾肾阳虚型肝癌患者的临床研究. 现代肿瘤医学. 2022(03): 471-475 .
    5. 柳彬,李志颖. 调强放疗联合肝动脉化疗栓塞术治疗原发性肝癌患者的效果. 中国民康医学. 2022(03): 30-32 .
    6. 余海滨,张克勤,冷向北,王文英,万萍,欧阳兵,杨文娟. 40~120μm直径三丙烯微球m-肝动脉化疗栓塞术治疗乏血供肝癌的疗效与安全性分析. 当代医学. 2022(13): 49-52 .
    7. 耿冀洲,杨小斌. 载药微球肝动脉化疗栓塞术治疗大肝癌的临床效果及安全性. 临床医学研究与实践. 2022(21): 67-70 .
    8. 张发恩. 肝动脉化疗栓塞联合放疗治疗中晚期肝癌的效果. 中国医药科学. 2022(12): 134-138 .
    9. 柯映平,叶绍光,卢舜彬. 肝动脉化疗栓塞术联合FOLFOX方案持续性动脉灌注化疗在巴塞罗那B期原发性肝癌患者中的应用效果. 中国当代医药. 2022(18): 73-76 .
    10. 谭鑫,王高兴,王佳,王君伟. 氩氦刀并肝动脉介入治疗原发性肝癌及对血清VEGF及MMP的影响研究. 临床和实验医学杂志. 2021(05): 493-496 .
    11. 张琦. 不同的放疗方法治疗原发性巨大肝癌的临床应用研究. 数理医药学杂志. 2021(07): 958-960 .
    12. 赵凯,薛晋峰,薛鹏飞,常鹏. 阿帕替尼对中晚期肝癌患者TACE术后血管生成因子水平的影响. 肝脏. 2021(06): 628-631 .
    13. 孙军,李拥军,沈智勇,黄洪华,张卫华,江娟. 国产CalliSpheres载药微球经导管肝动脉化疗栓塞治疗肝恶性肿瘤的效果研究. 实用临床医药杂志. 2020(08): 10-13 .

    Other cited types(1)

  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (1643) PDF downloads(319) Cited by(14)
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return