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中华介入放射学电子杂志

中华介入放射学电子杂志 ›› 2017, Vol. 05 ›› Issue (03) : 174 -178. doi: 10.3877/cma.j.issn.2095-5782.2017.03.013

所属专题： 专题评论； 文献；

肿瘤介入

CalliSpheres载药栓塞微球治疗中晚期肝癌临床效果评价
姜松1, 李桂杰1, 周祝谦1,†(), 牛威1   
  1. 1. 250014　山东济南，山东大学附属千佛山医院介入科
  • 收稿日期:2017-04-16 出版日期:2017-08-01
  • 通信作者: 周祝谦

Interventional chemoembolization with CalliSpheres-loaded microspheres for the treatment of advanced hepatocellular carcinoma

Song Jiang1, Guijie Li1, Zhuqian Zhou1,†(), Wei Niu1   

  1. 1. Department of Interventional Radiology, Qianfoshan Hospital attached Shandong University, Jinan 250014, China
  • Received:2017-04-16 Published:2017-08-01
  • Corresponding author: Zhuqian Zhou
  • About author:
    Corresponding author: Zhou Zhuqian,Email:
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姜松, 李桂杰, 周祝谦, 牛威. CalliSpheres载药栓塞微球治疗中晚期肝癌临床效果评价[J]. 中华介入放射学电子杂志, 2017, 05(03): 174-178.

Song Jiang, Guijie Li, Zhuqian Zhou, Wei Niu. Interventional chemoembolization with CalliSpheres-loaded microspheres for the treatment of advanced hepatocellular carcinoma[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2017, 05(03): 174-178.

目的：

探讨CalliSpheres载药栓塞微球治疗中晚期肝癌的临床效果和安全性。

方法：

对25例中晚期肝癌患者行导管肝动脉化疗栓塞术（TACE），并使用CalliSpheres载药栓塞微球进行栓塞，采用改良实体瘤疗效评价标准（mRECIST）评价治疗效果，比较患者治疗前后肝功能变化，记录不良反应及并发症发生情况。

结果：

本组25例患者均顺利接受CalliSpheres载药栓塞微球治疗，技术成功率为100%；25例患者随访6个月，根据mRECIST标准，3个月疾病缓解率（CR+PR）为80%，疾病控制率（CR+PR+SD）为88%，6个月疾病缓解率（CR+PR）为72%，疾病控制率（CR+PR+SD）为80%。术后3 d，肝功能变化主要表现为谷丙转氨酶（ALT）、谷草转氨酶（AST）及总胆红素升高，与术前差异有统计学意义，白蛋白变化不明显，与术前差异无统计学意义，术后3个月，肝功能基本恢复正常水平，与术前比较差异无统计学意义，所有患者均未出现胆汁漏并发感染、肝脓肿、肿瘤破裂出血及消化道出血等严重并发症。

结论：

对中晚期肝癌患者，应用CalliSpheres载药栓塞微球是一个新的选择，近期临床疗效及安全性良好，远期疗效尚待进一步观察。

关键词: 肝动脉化疗栓塞术, 肝癌, 可载药栓塞微球, CalliSpheres
Objective:

To evaluate the safety and clinical short-term efficacy of interventional embolization with CalliSpheres-loaded microspheres in treating advanced hepatocellular carcinoma.

Methods:

A total of 25 patients with advanced hepatocellular carcinoma underwent transcatheter arterial chemoembolization (TACE) plus using CalliSpheres-loaded microspheres treatment. The clinical and imaging data, complications of interventional treatment and prognosis were summarized and analyzed by modified response evaluation criteria in solid tumors (mRECIST); follow-up was performed on all patients.

Results:

The follow-up lasted 6 months. According to mRECIST, the 3-month objective response rate (CR+PR) was 80% and disease control rate (CR+PR+SD) was 88%; the 6-month objective response rate (CR+PR) was 72% and disease control rate (CR+PR+SD) was 80%. At day 3 after the procedure, the levels of ALT, AST and TBIL were increased, with a statistical significance compared with those before the operation. However, there was no significant difference in the level of albumin. At 3 months postoperatively, the indications of liver function returned to the normal level. And there was no significant difference between pre- and post-operation. No severe complications, such as bile leak with infection, liver abscess, abdominal hemorrhage, bleeding due to tumor rupture and gastrointestinal bleeding occurred in these patients.

Conclusion:

TACE performed with CalliSpheres-loaded microspheres is a novel and safe option for patients with advanced hepatocellular carcinoma. Its clinical short-term efficacy was satisfied, yet its long-term efficacy needs further studies.

Key words: Transcatheter arterial chemoembolization, Hepatocellular carcinoma, Drug-loaded microspheres, CalliSpheres
表1 患者术前资料
临床病理特征 例数 临床病理特征 例数
病因 ? BCLC分期 ?
? 乙肝 22 ? A期 0
? 未知 5 ? B期 21
肝硬化 ? ? C期 4
? 有 21 肿瘤范围 ?
? 无 4 ? 单叶 16
Child-Pugh分级 ? ? 双叶 9
? A级 21 肿瘤数量 ?
? B级 4 ? 1个 12
ECOG评分 ? ? 2～3个 5
? 0分 20 ? >3个 8
? 1分 5 ? ? ?
表2 术后不同时间的随访结果　例（%）
术后时间 CR PR SD PD CR+PR CR+PR+SD
3个月 2(8%) 18(72%) 2(8%) 3(12%) 20(80%) 22(88%)
6个月 1(4%) 17(68%) 2(8%) 5(20%) 18(72%) 20(80%)
图1 典型病例手术前后CT及造影图
表3 患者治疗前后肝功能变化比较　（±s）
时间 白蛋白（g/L） ALT（U/L） AST（U/L） 总胆红素（μmol/L）
术前 40.0±3.0 31.5±12.0 39.0±17.0 13.5±4.5
术后3 d 37.0±5.6 86.0±53.0a 132.0±82.0a 19.0±7.7a
术后3个月 38.0±4.6 33.5±10.0 42.0±15.5 14.5±6.5
F 0.64 6.37* 15.54* 9.75*
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