TACE术中应用三氧化二砷CalliSpheres载药栓塞微球治疗BCLC B期原发性肝癌13例
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摘要
目的观察TACE中应用三氧化二砷(ATO)CalliSpheres Bead(CB)(CBATO)治疗BCLC B期原发性肝癌的临床疗效。方法收集2017年1月至2017年9月13例TACE术中应用CBATO治疗BCLC-B期原发性肝癌患者,对患者临床资料、影像资料、实验室检查、介入治疗的并发症和预后等情况进行总结和分析。结果 13例患者随访9～15个月,中位随访时间为11个月,生存率100%。术后1、3、6、9个月的疾病缓解率(CR+PR)分别为76.9%、76.9%、69.2%、61.5%,疾病控制率(CR+PR+SD)分别92.3%、92.3%、92.3%、84.6%。所有患者均未出现肝功能衰竭、肾功能不全、骨髓抑制、肝脓肿、胆汁漏并发感染及消化道出血等严重并发症。结论 TACE术中应用CBATO治疗原发性肝癌安全有效、近期临床疗效好。
Objective To evaluate the clinic effect of transcatheter arterial chemoembolization(TACE) by using arsenic trioxide(ATO) drug-bearing CalliSpheres beads(CB) in treating BCLC stage B hepatocellular carcinoma(HCC). Methods The clinical data of 13 patients with advanced HCC, who received TACE by using CB loaded with ATO(CBATO) during the period from January 2017 to September 2017, were retrospectively analyzed. The clinical data, imaging materials, laboratory examinations, interventional complications, prognosis, etc., were summarized and evaluated. Results The patients were followed up for9-15 months, with a median period of 11 months. The survival rate was 100%. One, 3, 6 and 9 months after treatment, the disease remission(CR+PR) rates were 76.9%, 76.9%, 69.2% and 61.5% respectively, and the disease control rates were 92.3%, 92.3%, 92.3% and 84.6% respectively. In all 13 patients, no severe complications such as hepatic failure, renal insufficiency, bone marrow suppression, liver abscess, bile leakage complicated by infection and gastrointestinal bleeding occurred. Conclusion For the treatment of BCLC stage B HCC, TACE by using CBATO is safe and effective with reliable short-term effect.
Objective To evaluate the clinic effect of transcatheter arterial chemoembolization(TACE) by using arsenic trioxide(ATO) drug-bearing CalliSpheres beads(CB) in treating BCLC stage B hepatocellular carcinoma(HCC). Methods The clinical data of 13 patients with advanced HCC, who received TACE by using CB loaded with ATO(CBATO) during the period from January 2017 to September 2017, were retrospectively analyzed. The clinical data, imaging materials, laboratory examinations, interventional complications, prognosis, etc., were summarized and evaluated. Results The patients were followed up for9-15 months, with a median period of 11 months. The survival rate was 100%. One, 3, 6 and 9 months after treatment, the disease remission(CR+PR) rates were 76.9%, 76.9%, 69.2% and 61.5% respectively, and the disease control rates were 92.3%, 92.3%, 92.3% and 84.6% respectively. In all 13 patients, no severe complications such as hepatic failure, renal insufficiency, bone marrow suppression, liver abscess, bile leakage complicated by infection and gastrointestinal bleeding occurred. Conclusion For the treatment of BCLC stage B HCC, TACE by using CBATO is safe and effective with reliable short-term effect.
引文
[1]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].传染病信息, 2017, 30:111-127.
[2] Lu W, Li YH, He XF, et al. Necrosis and apoptosis in hepatocellular carcinoma following low-dose versus high-dose preoperative chemoembolization[J]. Cardiovasc Intervent Radiol,2008, 31:1133-1140.
[3] Huang K, Zhou Q, Wang R, et al. Doxorubicin-eluting beads versus conventional transarterial chemoembolization for the treatment of hepatocellular carcinoma[J]. J Gastroenterol Hepatol,2014, 29:920-925.
[4] Duan X, Li T, Han X, et al. The antitumor effect of Arsenic trioxide on hepatocellular carcinoma is enhanced by andrographolide[J]. Oncotarget, 2017, 8:90905-90915.
[5] Dugo EB, Yedjou CG, Stevens JJ, et al. Therapeutic Potential of Arsenic Trioxide(ATO)in Treatment of Hepatocellular Carcinoma_Role of Oxidative Stress in ATOInduced Apoptosis[J]. Ann Clin Pathol, 2017, 5:pii:1101.
[6] Yang H, Zhou S, Shen R, et al. Evaluation on efficacy and safety of arsenic trioxide plus transcatheter arterial chemoembolization versus transcatheter arterial chemoembolization alone for unresectable primary liver cancer[J]. Asian Pac J Cancer Prev,2017, 18:2695-2701.
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[9]赵巍,胡亚男,蒋学君,等.三氧化二砷诱导肝癌细胞凋亡的机制研究[J].四川大学学报医学, 2014, 45:739-743.
[10] Zhao XS, Song PL, Sun B, et al. Arsenic trioxide inhibits metastatic potential of mouse hepatoma H-22 cells in vitro and in vivo[J]. Hepatobiliary Pancreat Dis Int, 2009, 8:510-517.
[11] Xu HY, Yang YL, Liu SM, et al. Effect of Arsenic trioxide on human hepatocarcinoma in nude mice[J]. World J Gastroenterol,2004, 10:3677-3679.
[12] Tingting R, Wei G, Changliang P, et al. Arsenic trioxide inhibits osteosarcoma cell invasiveness via MAPK signaling pathway[J]. Cancer Biol Ther, 2010, 10:251-257.
[13]郭换珍,赵直光,唐中权,等.三氧化二砷治疗晚期原发性肝癌的临床观察[J].中国肝脏病杂志·电子版, 2014, 6:5-7.
[14]张波,孟紫强.砷的致癌,致畸及致突变作用研究进展[J].癌变·畸变·突变, 1997, 9:180-181.
[15] Hu HT, Yao QJ, Meng YL, et al. Arsenic trioxide intravenous infusion combined with transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with pulmonary metastasis:long-term outcome analysis[J]. J Gastroenterol Hepatol,2017, 32:295-300.
[16] Song MJ, Chun HJ, Song DS, et al. Comparative study between doxorubicin-eluting beads and conventional transarterial chemoembolization for treatment of hepatocellular carcinoma[J]. J Hepatol, 2012, 57:1244-1250.
[17] Zhang S, Huang C, Li Z, et al. Comparison of pharmacokinetics and drug release in tissues after transarterial chemoembolization with doxorubicin using diverse lipiodol emulsions and CalliSpheres Beads in rabbit livers[J]. Drug Deliv, 2017, 24:1011-1017.
[18] Malagari K, Pomoni M, Moschouris H, et al. Chemoembolization of hepatocellular carcinoma with hepasphere 30-60 mum. safety and efficacy study[J]. Cardiovasc Intervent Radiol, 2014, 37:165-175.
[19]赵倩,颜志平.载药微球经导管动脉化疗栓塞治疗肝癌研究进展[J].介入放射学杂志, 2017, 26:1052-1056.
[20] Huang K, Zhou Q, Wang R, et al. Doxorubicin-eluting beads versus conventional transarterial chemoembolization for the treatment of hepatocellular carcinoma[J]. J Gastroenterol Hepatol,2014, 29:920-925.
[21]刘金,曹刚,张根山,等.国产CalliSpheres载药微球治疗原发性肝癌12例[J].介入放射学杂志, 2017, 26:993-998.
[2] Lu W, Li YH, He XF, et al. Necrosis and apoptosis in hepatocellular carcinoma following low-dose versus high-dose preoperative chemoembolization[J]. Cardiovasc Intervent Radiol,2008, 31:1133-1140.
[3] Huang K, Zhou Q, Wang R, et al. Doxorubicin-eluting beads versus conventional transarterial chemoembolization for the treatment of hepatocellular carcinoma[J]. J Gastroenterol Hepatol,2014, 29:920-925.
[4] Duan X, Li T, Han X, et al. The antitumor effect of Arsenic trioxide on hepatocellular carcinoma is enhanced by andrographolide[J]. Oncotarget, 2017, 8:90905-90915.
[5] Dugo EB, Yedjou CG, Stevens JJ, et al. Therapeutic Potential of Arsenic Trioxide(ATO)in Treatment of Hepatocellular Carcinoma_Role of Oxidative Stress in ATOInduced Apoptosis[J]. Ann Clin Pathol, 2017, 5:pii:1101.
[6] Yang H, Zhou S, Shen R, et al. Evaluation on efficacy and safety of arsenic trioxide plus transcatheter arterial chemoembolization versus transcatheter arterial chemoembolization alone for unresectable primary liver cancer[J]. Asian Pac J Cancer Prev,2017, 18:2695-2701.
[7] Meyer T, Palmer DH, Cheng AL, et al. mRECIST to predict survival in advanced hepatocellular carcinoma:analysis of two randomised phaseⅡtrials comparing nintedanib vs sorafenib[J]. Liver Int, 2017, 37:1047-1055.
[8]彭贵主,叶啟发,王垒.三氧化二砷治疗肝癌的出路—联合用药[J].肝胆胰外科杂志, 2016, 28:441-447.
[9]赵巍,胡亚男,蒋学君,等.三氧化二砷诱导肝癌细胞凋亡的机制研究[J].四川大学学报医学, 2014, 45:739-743.
[10] Zhao XS, Song PL, Sun B, et al. Arsenic trioxide inhibits metastatic potential of mouse hepatoma H-22 cells in vitro and in vivo[J]. Hepatobiliary Pancreat Dis Int, 2009, 8:510-517.
[11] Xu HY, Yang YL, Liu SM, et al. Effect of Arsenic trioxide on human hepatocarcinoma in nude mice[J]. World J Gastroenterol,2004, 10:3677-3679.
[12] Tingting R, Wei G, Changliang P, et al. Arsenic trioxide inhibits osteosarcoma cell invasiveness via MAPK signaling pathway[J]. Cancer Biol Ther, 2010, 10:251-257.
[13]郭换珍,赵直光,唐中权,等.三氧化二砷治疗晚期原发性肝癌的临床观察[J].中国肝脏病杂志·电子版, 2014, 6:5-7.
[14]张波,孟紫强.砷的致癌,致畸及致突变作用研究进展[J].癌变·畸变·突变, 1997, 9:180-181.
[15] Hu HT, Yao QJ, Meng YL, et al. Arsenic trioxide intravenous infusion combined with transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with pulmonary metastasis:long-term outcome analysis[J]. J Gastroenterol Hepatol,2017, 32:295-300.
[16] Song MJ, Chun HJ, Song DS, et al. Comparative study between doxorubicin-eluting beads and conventional transarterial chemoembolization for treatment of hepatocellular carcinoma[J]. J Hepatol, 2012, 57:1244-1250.
[17] Zhang S, Huang C, Li Z, et al. Comparison of pharmacokinetics and drug release in tissues after transarterial chemoembolization with doxorubicin using diverse lipiodol emulsions and CalliSpheres Beads in rabbit livers[J]. Drug Deliv, 2017, 24:1011-1017.
[18] Malagari K, Pomoni M, Moschouris H, et al. Chemoembolization of hepatocellular carcinoma with hepasphere 30-60 mum. safety and efficacy study[J]. Cardiovasc Intervent Radiol, 2014, 37:165-175.
[19]赵倩,颜志平.载药微球经导管动脉化疗栓塞治疗肝癌研究进展[J].介入放射学杂志, 2017, 26:1052-1056.
[20] Huang K, Zhou Q, Wang R, et al. Doxorubicin-eluting beads versus conventional transarterial chemoembolization for the treatment of hepatocellular carcinoma[J]. J Gastroenterol Hepatol,2014, 29:920-925.
[21]刘金,曹刚,张根山,等.国产CalliSpheres载药微球治疗原发性肝癌12例[J].介入放射学杂志, 2017, 26:993-998.