Comparison on adverse reactions between HepaSphere-loaded microspheres and lipiodol emulsion from transcatheter hepatic arterial chemoembolization on large primary liver cancer

doi:10.3877/cma.j.issn.2095-5782.2018.02.002

Abstract

Abstract:

Objective:

To compare the adverse reactions of HepaSphere-loaded microspheres and lipiodol emulsion as embolization agents in patients with hepatocellular carcinoma (HCC) submitted to transcatheter hepatic arterial chemoembolization (TACE) .

Methods:

Patients diagnosed as large primary liver cancer (129 cases) were all treated with TACE in Guangdong Provincial People's Hospital from March 2015 to May 2016. Among them, 68 cases (microsphere group) used HepaSphere-loaded microspheres as TACE embolization material, and the other 61 cases (lipiodol group) used iodinated oil emulsifier as TACE embolization material. We then statistically analyzed the adverse events (such as fever, pain, nausea and vomiting) and liver function during and after TACE in both groups.

Results:

The most common adverse reaction during TACE was hepatalgia, the level of which in the microsphere group was lower than that of the lipiodol group (P<0.05) . Fever, pain, nausea, vomiting and liver dysfunction were common postoperative adverse reactions of TACE. Compared with the lipiodol group, the microspheres group had lower degree of fever (P<0.05) and postoperative pain (P<0.05) . There were no significant differences in the levels of AST, ALT, ALB, TBIL and PT between the two groups 3 d after TACE, whereas the AST level of the microspheres group was lower than that of the lipiodol group 7 d after TACE. The difference was statistically significant which meant in terms of postoperative recovery, the microsphere group gained better results than the lipiodol group.

Conclusions:

These results suggest that the microsphere group shows less adverse reactions during or after TACE and better recovery of liver function after the operation.

Key words: Transcatheter arterial chemoembolization, Hepatocellular carcinoma, HepaSphere microsphere, Adverse reaction

Lige Qiu, Ruosi Liang, Yong Li, Baoshan Hu, Youbing Zheng, Xu He, Ligong Lu. Comparison on adverse reactions between HepaSphere-loaded microspheres and lipiodol emulsion from transcatheter hepatic arterial chemoembolization on large primary liver cancer[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2018, 06(02): 99-103.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhjrfsxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-5782.2018.02.002

https://zhjrfsxdzzz.cma-cmc.com.cn/EN/Y2018/V06/I02/99

Figures/Tables 3

References 14

[1]	Yang T, Lu JH, Wu MC. Hepatocellular carcinoma in China[J]. Student BMJ, 2010, 18: c 1026.
[2]	李麟荪，滕皋军.介入放射学：临床与并发症[M].北京:人民卫生出版社，2010: 431.
[3]	Bruix J, Sherman M. Management of hepatocellular carcinoma: an update[J]. Hepatology, 2011, 53(3): 1020-1022.
[4]	Benson AB 3rd, Abrams TA, Ben-Josef E, et al. NCCN clinical practice guidelines in oncology: hepatobiliary cancers[J]. J Natl Compr Canc Netw, 2009, 7(4): 350-391.
[5]	European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma[J]. J Hepatol, 2012, 56(4): 908-943.
[6]	Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma Chemoembolization improves survival[J]. Hepatology, 2003, 37(2):429-442.
[7]	Cammà C, Schepis F, Orlando A, et al. Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials[J]. Radiology, 2002, 224(1):47-54.
[8]	Lee CS, Kim SJ, Choi JW, et al. Cerebral lipiodol embolism proven by dual-energy computed tomography：a case report[J]. J Comput Assist Tomogr, 2010, 34(1):105-106.
[9]	Khankan AA, Osuga K, Hori S, et al. Embolic effects of superabsorbent polymer microspheres in rabbit renal model：comparison with tris-acryl gelatin microspheres and polyvinyl alcohol[J]. Radiat Med, 2004, 22(6):384-390.
[10]	Bilbao JI, de Luis E, García de Jalón JA, et al. Comparative study of four different spherical embolic particles in an animal model：a morphologic and histologic evaluation[J]. J Vasc Interv Radiol, 2008, 19(11):1625-1638.
[11]	Klass D, Owen D, Buczkowski A, et al. The effect of doxorubicin loading on response and toxicity with drug-eluting embolization in resectable hepatoma: a dose escalation study[J]. Anticancer Res, 2014, 34(7):3597-3606.
[12]	姜松，李桂杰，周祝谦, 等. CalliSpheres载药栓塞微球治疗中晚期肝癌临床效果评价[J/CD].中华介入放射学电子杂志, 2017, 5(3):174-178.
[13]	Gupta S, Wright KC, Ensor J, et al. Hepatic arterial embolization with doxorubicin-loaded superabsorbent polymer microspheres in a rabbit liver tumor model[J]. Cardiovasc Intervent Radiol, 2011, 34(5):1021-1030.
[14]	Malagari K, Pomoni M, Moschouris H, et al. Chemoembolization of hepatocellular carcinoma with HepaSphere 30~60 μm. Safety and efficacy study[J]. Cardiovasc Intervent Radiol, 2014, 37(1): 165-175.

参数		微球组(n=68)	碘油组(n=61)	统计量	P值
性别		?	?	χ²=0.318	0.573
?	男	52(76.5)	44(72.1)	?	?
?	女	16(23.5)	17(27.9)	?	?
年龄（岁）		55.5±12.1	57.2±11.5	t=-0.827	0.410
肿瘤最大直径(cm)		5.94±0.90	6.19±0.94	t=-1.517	0.132
肝炎病史		?	?	χ²=0.844	0.358
?	有	59(86.8)	56(91.8)	?	?
?	无	9(13.2)	5(8.2)	?	?
病灶数量（个）		?	?	Z= -1.334	0.182
?	1	20(29.4)	13(21.3)	?	?
?	1~3	30(44.1)	26(42.6)	?	?
?	多结节	18(26.5)	22(36.1)	?	?
PS评分（分）		?	?	Z=-0.033	0.973
?	0	43(63.2)	37(60.7)	?	?
?	1	20(29.4)	23(37.7)	?	?
?	2	5(7.4)	1(1.6)	?	?
门脉侵犯		?	?	χ²=2.546	0.111
?	有	15(22.1)	7(11.5)	?	?
?	无	53(77.9)	54(88.5)	?	?
BCLC分期		?	?	Z =-0.691	0.490
?	A期	6(8.8)	7(11.5)	?	?
?	B期	27(39.7)	26(42.6)	?	?
?	C期	35(51.5)	28(45.9)	?	?
术前Child-Pugh分级		?	?	Z=-0.365	0.715
?	A级	54(79.4)	50(82.0)	?	?
?	B级	14(20.6)	11(18.0)	?	?

参数		微球组(n=68)	碘油组(n=61)	统计量	P值
性别		?	?	χ²=0.318	0.573
?	男	52(76.5)	44(72.1)	?	?
?	女	16(23.5)	17(27.9)	?	?
年龄（岁）		55.5±12.1	57.2±11.5	t=-0.827	0.410
肿瘤最大直径(cm)		5.94±0.90	6.19±0.94	t=-1.517	0.132
肝炎病史		?	?	χ²=0.844	0.358
?	有	59(86.8)	56(91.8)	?	?
?	无	9(13.2)	5(8.2)	?	?
病灶数量（个）		?	?	Z= -1.334	0.182
?	1	20(29.4)	13(21.3)	?	?
?	1~3	30(44.1)	26(42.6)	?	?
?	多结节	18(26.5)	22(36.1)	?	?
PS评分（分）		?	?	Z=-0.033	0.973
?	0	43(63.2)	37(60.7)	?	?
?	1	20(29.4)	23(37.7)	?	?
?	2	5(7.4)	1(1.6)	?	?
门脉侵犯		?	?	χ²=2.546	0.111
?	有	15(22.1)	7(11.5)	?	?
?	无	53(77.9)	54(88.5)	?	?
BCLC分期		?	?	Z =-0.691	0.490
?	A期	6(8.8)	7(11.5)	?	?
?	B期	27(39.7)	26(42.6)	?	?
?	C期	35(51.5)	28(45.9)	?	?
术前Child-Pugh分级		?	?	Z=-0.365	0.715
?	A级	54(79.4)	50(82.0)	?	?
?	B级	14(20.6)	11(18.0)	?	?

参数		微球组(n=68)	碘油组(n=61)	Z值	P值
术中疼痛		?	?	-5.854	<0.001
?	0级	67(98.5)	34(55.7)	?	?
?	Ⅰ级	1(1.5)	22(36.1)	?	?
?	Ⅱ级	0(0.0)	5(8.2)	?	?
?	Ⅲ级	0(0.0)	0(0.0)	?	?
?	秩均值	51.91	79.59	?	?
恶心、呕吐		?	?	-1.396	0.163
?	0级	44(64.7)	32(52.5)	?	?
?	Ⅰ级	7(10.3)	8(13.1)	?	?
?	Ⅱ级	17(25.0)	21(34.4)	?	?
?	Ⅲ级	0(0.0)	0(0.0)	?	?
?	秩均值	61.18	69.25	?	?
发热		?	?	-2.798	0.005
?	0级	56(82.4)	36(59.0)	?	?
?	Ⅰ级	7(10.3)	16(26.2)	?	?
?	Ⅱ级	4(5.9)	9(14.8)	?	?
?	Ⅲ级	1(1.5)	0(0.0)	?	?
?	秩均值	58.07	72.72	?	?
术后疼痛		?	?	-2.569	0.010
?	0级	41(60.3)	24(39.3)	?	?
?	Ⅰ级	14(20.6)	13(21.3)	?	?
?	Ⅱ级	11(16.2)	23(37.7)	?	?
?	Ⅲ级	2(2.9)	1(1.6)	?	?
?	秩均值	57.64	73.20	?	?

参数		微球组(n=68)	碘油组(n=61)	Z值	P值
术中疼痛		?	?	-5.854	<0.001
?	0级	67(98.5)	34(55.7)	?	?
?	Ⅰ级	1(1.5)	22(36.1)	?	?
?	Ⅱ级	0(0.0)	5(8.2)	?	?
?	Ⅲ级	0(0.0)	0(0.0)	?	?
?	秩均值	51.91	79.59	?	?
恶心、呕吐		?	?	-1.396	0.163
?	0级	44(64.7)	32(52.5)	?	?
?	Ⅰ级	7(10.3)	8(13.1)	?	?
?	Ⅱ级	17(25.0)	21(34.4)	?	?
?	Ⅲ级	0(0.0)	0(0.0)	?	?
?	秩均值	61.18	69.25	?	?
发热		?	?	-2.798	0.005
?	0级	56(82.4)	36(59.0)	?	?
?	Ⅰ级	7(10.3)	16(26.2)	?	?
?	Ⅱ级	4(5.9)	9(14.8)	?	?
?	Ⅲ级	1(1.5)	0(0.0)	?	?
?	秩均值	58.07	72.72	?	?
术后疼痛		?	?	-2.569	0.010
?	0级	41(60.3)	24(39.3)	?	?
?	Ⅰ级	14(20.6)	13(21.3)	?	?
?	Ⅱ级	11(16.2)	23(37.7)	?	?
?	Ⅲ级	2(2.9)	1(1.6)	?	?
?	秩均值	57.64	73.20	?	?

组别	ALT(mmol/L)			AST(mmol/L)
组别	术前	术后3 d	术后7 d	术前	术后3 d	术后7 d
微球组	32.78±8.30	88.42±41.03	52.70±29.91	38.31±31.79	125.75±30.02	54.69±20.71
碘油组	33.42±9.14	92.72±42.28	47.50±23.22	46.97±30.56	123.65±26.29	62.33±22.57
t值	0.419	0.586	0.401	1.572	0.424	1.995
P值	0.676	0.559	0.467	0.118	0.672	0.048
组别	ALB(g/L)			TBIL(mmol/L)			PT(s)
组别	术前	术后3 d	术后7 d	术前	术后3 d	术后7 d	术前	术后3 d	术后7 d
微球组	14.92±4.72	18.17±7.31	15.13±6.41	38.66±3.77	35.97±5.44	38.27±3.91	15.59±1.37	23.48±2.24	19.30±2.40
碘油组	13.68±4.68	20.38±6.54	13.68±5.97	37.95±4.30	36.28±5.00	37.58±4.06	15.69±1.44	23.89±2.36	19.09±2.55
t值	1.498	1.801	1.318	0.999	0.334	0.985	-0.379	-1.017	0.476
P值	0.137	0.074	0.188	0.320	0.739	0.327	0.706	0.311	0.635

Please choose a citation manager

Content to export