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首页> 外文期刊>Journal of vascular and interventional radiology: JVIR >Embolization efficacy and treatment effectiveness of transarterial therapy for unresectable hepatocellular carcinoma: a case-controlled comparison of transarterial ethanol ablation with lipiodol-ethanol mixture versus transcatheter arterial chemoembo
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Embolization efficacy and treatment effectiveness of transarterial therapy for unresectable hepatocellular carcinoma: a case-controlled comparison of transarterial ethanol ablation with lipiodol-ethanol mixture versus transcatheter arterial chemoembo

机译：经动脉介入治疗不可切除的肝细胞癌的栓塞疗效和治疗效果：病例对照比较：碘油-乙醇混合液与经导管动脉化疗栓塞术经皮乙醇切除

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PURPOSE: To compare the embolization efficacy and treatment effectiveness of transarterial ethanol ablation (TEA) versus those of chemoembolization and evaluate the correlation between embolization efficacy and treatment effectiveness of these treatments for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A case-controlled study was undertaken with 30 patients in each group matched based on Child-Pugh grade, tumor characteristics, and performance status. Primary endpoints were embolization efficacy (ie, Lipiodol retention within tumor at 2 months) and treatment effectiveness as evaluated by tumor response, disease progression, progression-free survival, and overall survival. The secondary endpoint was correlation between embolization efficacy and treatment effectiveness. RESULTS: Lipiodol retention was greater in the TEA group (89.5% +/- 10.7% vs 47.5% +/- 21.2%; P < .0001). The tumor progression rate at 1 year was higher in the chemoembolization group (five of 30 vs zero of 30; P = .0261). One-and 2-year overall survival rates were higher in the TEA group (93.3% and 80.0%, respectively, vs 73.3% and 43.3%, respectively; P = .0053). One- and 2-year extrahepatic disease progression rates were lower in the TEA group (P = .0002). There were no differences in progression-free survival and intrahepatic disease progression rates at 1 and 2 years. Patients with greater Lipiodol retention (ie, >60%) had better treatment outcomes at 1 year than those with lesser retention, with higher overall survival rates (88.9% vs 66.7%; P = .0192), lower intrahepatic disease progression rates (25.6% vs 59.4%; P = .0169), lower extrahepatic disease progression rates (0.31% vs 35.5%; P = .0047), and higher progression-free survival rates (72.1% vs 36.3%; P = .005). CONCLUSIONS: The embolization efficacy and treatment effectiveness of TEA are probably superior to those of chemoembolization for HCC.
机译：目的：比较经动脉乙醇切除术（TEA）和化学栓塞术的栓塞疗效和治疗效果，并评估这些治疗肝癌（HCC）的栓塞效果和治疗效果之间的相关性。材料与方法：根据Child-Pugh分级，肿瘤特征和表现状态，每组30例患者进行了病例对照研究。主要终点为栓塞疗效（即2个月时脂质体在肿瘤内的保留）和通过肿瘤反应，疾病进展，无进展生存期和总体生存期评估的治疗效果。次要终点是栓塞疗效与治疗效果之间的相关性。结果：TEA组中的碘油滞留率更高（89.5％+/- 10.7％对47.5％+/- 21.2％; P <.0001）。化学栓塞组在1年时的肿瘤进展率更高（30分之5与30分的零; P = .0261）。 TEA组的一年和两年总体生存率更高（分别为93.3％和80.0％，而分别为73.3％和43.3％; P = .0053）。 TEA组的一年和两年肝外疾病进展率较低（P = .0002）。 1年和2年的无进展生存期和肝内疾病进展率无差异。脂质碘Lip留率较高（即> 60％）的患者在一年后的治疗结果要好于保留血脂较少的患者，其总生存率较高（88.9％对66.7％; P = .0192），肝内疾病进展率较低（25.6） ％vs. 59.4％; P = .0169），较低的肝外疾病进展率（0.31％vs 35.5％; P = .0047）和较高的无进展生存率（72.1％vs 36.3％; P = .005）。结论：TEA的栓塞疗效和治疗效果可能优于HCC的化学栓塞效果。

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