论文部分内容阅读
BACKGROUND:Chemoembolization with doxorubucin-eluting beads(DEB) has been used to treat hepatocellular carcinoma(HCC) since 2007. This study compared the efficacy and survival between transarterial chemoembolization(TACE) with DEB and conventional approach(c TACE) in HCC treatment.METHODS: This retrospective case-control study compared the overall survival and tumor response of HCC patients to c TACE(n=190) and DEB(n=143) by the reassessment of computed tomography and serum alpha-fetoprotein(AFP). Multivariate analysis was used to determine the factors affecting tumor response.RESULTS: The median post-treatment to pre-treatment AFP level was 0.8 for a DEB session(n=258) and 1.0 for a c TACE session(n=452), showing a significantly greater decrease in AFP after DEB(P<0.05). More patients in the DEB group achieved objective response(complete and partial) compared with those in the c TACE group(P<0.05). Objective tumor response after DEB vs c TACE was 34.8% vs 15.4% in 0-3 months(P=0.001), 37.1% vs 20.0% in 3-6 months(P<0.05), and 50.0% vs 30.0% in 6-12 months(P=0.093). DEB predicted a 3.604 times odds of achieving at least one objective tumor response in a patient when compared to cT ACE(P<0.0001). The median survival from first transcatheter therapy of patients havingundergone at least once DEB was 12.53 months, while those having received c TACE only was 10.53 months(P=0.086). A tendency of improved survival appeared to maintain until >80 months after the first TACE session in the DEB group. CONCLUSION: DEB is a safe alternative to c TACE in HCC patients with better therapeutic efficacy.
BACKGROUND: Chemoembolization with doxorubucin-eluting beads (DEB) has been used to treat hepatocellular carcinoma (HCC) since 2007. This study compared the efficacy and survival between transarterial chemoembolization (TACE) with DEB and conventional approach (c TACE) in HCC treatment. METHODS: This retrospective case-control study compared the overall survival and tumor response of HCC patients to c TACE (n = 190) and DEB (n = 143) by the reassessment of computed tomography and serum alpha-fetoprotein (AFP). Multivariate analysis was used to determine the factors affecting tumor response .RESULTS: The median post-treatment to pre-treatment AFP level was 0.8 for a DEB session (n = 258) and 1.0 for ac TACE session (n = 452), showing a significantly greater decrease in AFP after DEB (P <0.05). More patients in the DEB group achieved objective response (complete and partial) compared with those in the c TACE group (P <0.05). Objective tumor response after DEB vs c TACE was 34.8% vs 15.4% in 0-3 months (P = 0.001), 37.1% vs 20.0% in 3-6 months (P <0.05), and 50.0% vs 30.0% in 6-12 months (P = 0.093). DEB predicted a 3.604 times odds of achieving at least one objective tumor response in a patient When compared to cT ACE (P <0.0001). The median survival from first transcatheter therapy of patients having undergone at least once prior to BEB was 12.53 months, while those having received TACE only was 10.53 months (P = 0.086). A tendency of improved survival CONCUSION: DEB is a safe alternative to c TACE in HCC patients with better therapeutic efficacy.