Hepasphere载药微球栓塞治疗中晚期肝细胞肝癌的安全性及疗效分析

目的:采用Hepasphere载药微球栓塞（DEB-TACE）治疗中晚期肝细胞癌（HCC），观察该疗法的安全性及疗效。方法:评估接受DEB-TACE治疗HCC患者术前术后肝功能，血清AFP水平变化以及术后不良反应、短期疗效和生存期。结果:从2014年7月到2017年10月纳入研究HCC患者24人（男21人，女3人），中位年龄为57（24～82）岁，肿瘤平均最长径为（9.3±4.0）cm。根据BCLC分期，包括B期5人，C期19人。合计接受DEB-TACE治疗31人次，成功率100%。DEB-TACE术前、后ALB、ALT、AST、T.BIL和AFP无统计学意义（P>0.5）。DEB-TACE术后30天内未见肝梗死等严重并发症，不良反应包括发热6例（19.4%）、恶心1例（3.2%），肝区疼痛4例（12.9%）。随访时间范围从3.9～40.0个月，平均随访13.2个月。根据改良RECST标准，治疗后1、3、6个月获得的疾病缓解率为58.3%、45.8%和40.9%，疾病控制率为91.7%、83.3%和86.4%。1、2年的存活率为87.5%和58.3%。截止到研究终点，中位生存期为25.6个月。结论:DEB-TACE对治疗中晚期HCC安全好，短期疗效稳定。

The safety and efficacy of Hepasphere microspheres in the treatment of advanced hepatocellular carcinoma

Objective:To explore the efficacy and safety of drug-eluting bead (DEB) embolization (DEB-TACE) in the treatment of advanced hepatocellular carcinoma (HCC).Methods:The liver function，AFP，adverse reactions，tumor response and overall survival in patients with HCC undergoing DEB-TACE treatment were assessed.Results:There were 24 HCC patients (21 males and 3 females) were enrolled into this study from July 2014 to October 2017，with a median age of 57 (24~82) years and a mean lesion size of (9.3±4.0) cm.According to the BCLC staging，5 patients were in stage B and 19 patients were in stage C.The operative success rates were 100% with a total treatment of 31 times.Preoperative and postoperative ALB，ALT，AST，T.BIL and AFP were not statistically significant (P>0.5).There were no serious complications such as hepatic infarction within 30 days after DEB-TACE，and adverse reactions included fever in 6 cases (19.4%)，nausea in 1 case (3.2%)，and pain in the liver area in 4 cases (12.9%).The follow-up period ranged from 3.9 to 40.0 months，with an average follow-up time of 13.2 months.According to the mRECST standard，1，3，and 6 months after treatment，the tumor remission rate was 58.3%，45.8%and 40.9% and the tumor control rates were 91.7%，83.3% and 86.4%.The 1，and 2 year survival percentages were 87.5% and 58.3%，respectively.The median overall survival was 25.6 months when the study was censored.Conclusion:DEB-TACE with Hepasphere beads is safe for treatment of advanced HCC，and the short-term effect is stable.