Efficacy and safety of transhepatic arterial chemoembolization with drug-loaded microspheres in unresectable primary liver cancer.

IF 2.5 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Jun Deng, Yan-Hong Mi, Le Xie, Xiong-Xing Sun, Dan-Hong Liu, Hua-Jun Long, Li-Yong He, Da-Hua Wu, Hong-Cai Shang
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Abstract

Background: Transhepatic arterial chemoembolization (TACE), as a local treatment, has been widely used in the treatment of unresectable liver cancer. The introduction of drug carrier microspheres has brought new hope for the therapeutic effect of TACE. Microspheres can realize the slow release and directional delivery of drugs, reduce systemic toxicity and improve local curative effect.

Aim: To compare the effectiveness of traditional transcatheter arterial chemoembolization against microsphere-assisted transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma that is incurable.

Methods: We searched the PubMed, Embase, Cochrane Library, and CNKI databases for clinical trials of drug-luting beads TACE (DEB-TACE) vs conventional TACE (cTACE) for the treatment of unresectable liver cancer. We screened references based on inclusion and exclusion criteria and then selected valid data for meta-analysis using RevMan 53 software. The complete response (CR) rate, partial response (PR) rate, postoperative stable disease (SD) rate, and 6-month and 12-month survival rates were compared.

Results: A total of 12 articles were included, including 1177 patients, 519 of whom received DEB-TACE and 658 of whom received cTACE. The CR rate in the DEB-TACE group was much greater than that in the cTACE group [relative risk (RR) = 1.42, 95%CI: 1.18-1.72, P = 0.0002]. The 12-month survival rate significantly increased (RR = 1.09; 95%CI: 1.01- 1.17, P = 0.03); the PR rate (RR = 1.13; 95%CI: 0.97-1.30, P = 0.12); the SD rate (RR = 0.82; 95%CI: 0.64-1.05, P = 0.12); and the 6-month survival rate (RR = 1.05; 95%CI: 1.00-1.10, P = 0.07). There was no significant difference (P < 0.05).

Conclusion: Compared with those of iodized oil TACE, the drug-loaded microspheres tended to have therapeutic advantages.

载药微球经肝动脉化疗栓塞治疗不可切除原发性肝癌的疗效和安全性。
背景:经肝动脉化疗栓塞(TACE)作为一种局部治疗方法,已广泛应用于不可切除肝癌的治疗。药物载体微球的引入为TACE的治疗效果带来了新的希望。微球可实现药物的缓释和定向给药,降低全身毒性,提高局部疗效。目的:比较传统经导管动脉化疗栓塞与微球辅助经导管动脉化疗栓塞治疗难治性肝癌的疗效。方法:检索PubMed、Embase、Cochrane Library和CNKI数据库,检索药物治疗珠粒TACE (DEB-TACE)与常规TACE (cTACE)治疗不可切除肝癌的临床试验。我们根据纳入和排除标准筛选参考文献,然后使用RevMan 53软件选择有效数据进行meta分析。比较两组患者的完全缓解(CR)率、部分缓解(PR)率、术后疾病稳定(SD)率以及6个月和12个月生存率。结果:共纳入12篇文献,共纳入1177例患者,其中519例患者接受DEB-TACE治疗,658例患者接受cTACE治疗。DEB-TACE组的CR率明显高于cTACE组[相对危险度(RR) = 1.42, 95%CI: 1.18-1.72, P = 0.0002]。12个月生存率显著提高(RR = 1.09;95%ci: 1.01- 1.17, p = 0.03);PR率(RR = 1.13);95%ci: 0.97-1.30, p = 0.12);SD率(RR = 0.82;95%ci: 0.64-1.05, p = 0.12);6个月生存率(RR = 1.05;95%ci: 1.00-1.10, p = 0.07)。两组间差异无统计学意义(P < 0.05)。结论:与碘化油TACE相比,载药微球更具治疗优势。
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
World Journal of Gastrointestinal Oncology
World Journal of Gastrointestinal Oncology Medicine-Gastroenterology
CiteScore
4.20
自引率
3.30%
发文量
1082
期刊介绍: The World Journal of Gastrointestinal Oncology (WJGO) is a leading academic journal devoted to reporting the latest, cutting-edge research progress and findings of basic research and clinical practice in the field of gastrointestinal oncology.
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