TACE vs. TARE for HCC ≥ 8 cm: A propensity score analysis.

IF 2.3 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Abdominal Radiology Pub Date : 2024-09-25 DOI:10.1007/s00261-024-04573-5

Nhan Hien Phan, Ho Jong Chun, Jung Suk Oh, Su Ho Kim, Byung Gil Choi

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Abstract

Objective: This study aimed to compare transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) as first-line treatments for unresectable HCC > 8 cm.

Methods: This retrospective study analyzed 129 HCC patients with tumor diameters greater than 8 cm from January 2010 to December 2021, including 40 patients who received TARE, and 89 patients treated with TACE as primary treatment. Following Propensity Score Matching (PSM), 40 patients from each group were harmonized for baseline characteristics. Tumor responses were evaluated using mRECIST criteria, and survival outcomes were compared between treatment groups using Kaplan-Meier curves and the Log-rank test.

Results: There was no significant difference in the objective response rate (ORR) and disease control rate (DCR) at 3, 6, and 12 months between the two groups; ORR and DCR were 72.6%, 83.1% in TACE group vs. 72.5%. 87.5% in TARE group for best tumor response (p-values: 0.625 and 0.981, respectively). Overall survival (OS) and progression-free survival (PFS) between the two groups were comparable pre- and post-PSM. After PSM, the OS was 33.2 months (20.0-58.6) in TACE group and 38.1 months (13.8-98.1) in TARE group (p = 0.53), while PFS was 11.5 months (7.7-18.4) and 9.1 months (5.2-23.8) respectively. After PSM, post-embolization syndrome developed more in TACE group (100% vs. 75%, p = 0.002). Major adverse events were 72% in TACE group vs. 5% in TARE group (p < 0.001).

Conclusions: TARE and TACE offer comparable efficacy in managing large HCC, with TARE providing a safer profile, suggesting its consideration as a preferable initial therapeutic approach for unresectable HCC patients with tumors larger than 8 cm.

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TACE与TARE治疗≥8厘米的HCC：倾向得分分析

研究目的本研究旨在比较经动脉化疗栓塞术（TACE）和经动脉放射栓塞术（TARE）作为不可切除的直径大于8厘米的HCC的一线治疗方法：这项回顾性研究分析了2010年1月至2021年12月期间肿瘤直径大于8厘米的129例HCC患者，其中40例接受了TARE治疗，89例以TACE作为主要治疗手段。经过倾向评分匹配（PSM）后，每组的40名患者的基线特征得到了统一。采用 mRECIST 标准评估肿瘤反应，并采用 Kaplan-Meier 曲线和 Log-rank 检验比较各治疗组的生存结果：结果：两组 3、6 和 12 个月的客观反应率（ORR）和疾病控制率（DCR）无明显差异；TACE 组的 ORR 和 DCR 分别为 72.6%、83.1%，TARE 组为 72.5%、87.5%。在最佳肿瘤反应方面，TARE 组的 ORR 和 DCR 分别为 72.6%、83.1%，TARE 组为 87.5%（P 值分别为 0.625 和 0.981）。两组的总生存期（OS）和无进展生存期（PFS）在PSM前后相当。PSM 后，TACE 组的 OS 为 33.2 个月（20.0-58.6），TARE 组为 38.1 个月（13.8-98.1）（P = 0.53），而 PFS 分别为 11.5 个月（7.7-18.4）和 9.1 个月（5.2-23.8）。PSM 后，TACE 组出现栓塞后综合征的比例更高（100% 对 75%，P = 0.002）。TACE组的主要不良事件发生率为72%，而TARE组为5%（P 结论：TACE和TARE的疗效相当：TARE 和 TACE 在治疗巨大 HCC 方面的疗效相当，TARE 的安全性更高，建议将其作为肿瘤大于 8 厘米的不可切除 HCC 患者的首选初始治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Abdominal Radiology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

8.30%

发文量

334

期刊介绍： Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section. Reasons to Publish Your Article in Abdominal Radiology: · Official journal of the Society of Abdominal Radiology (SAR) · Published in Cooperation with: European Society of Gastrointestinal and Abdominal Radiology (ESGAR) European Society of Urogenital Radiology (ESUR) Asian Society of Abdominal Radiology (ASAR) · Efficient handling and Expeditious review · Author feedback is provided in a mentoring style · Global readership · Readers can earn CME credits