PDF(Pubmed)
Abstract：
UNASSIGNED: Partial splenic embolization (PSE) combined with transarterial chemoembolization (TACE) has been reported in treatment of hepatocellular carcinoma (HCC) with cirrhotic hypersplenism and thrombocytopenia. However, efficacy and safety of repeated PSE when required are unclear. This study aims to investigate post-procedural changes in peripheral blood cell and hepatic function, progression-free survival (PFS), and safety of HCC patients with hypersplenism received TACE and repeated PSE compared to those received TACE alone.
UNASSIGNED: This retrospective study included 102 HCC patients with hypersplenism who received TACE (n = 73) or TACE+PSE (n = 29) from January 2014 to December 2021. Changes in peripheral blood cell and hepatic function were investigated at 1 week, 2, 6, 12, 18, and 24 months. TACE procedure sessions and adverse events were recorded. PFS and prognostic factors were analyzed.
UNASSIGNED: Despite response to initial PSE being limited, repeated PSE increased platelet (PLT) again, which peaked at 18 months. It also continued to improve red blood cell (RBC) and hemoglobin, which showed significant differences in changes from baseline between two groups until 24 months, as well as Child-Pugh scores at 12 and 18 months. Mean TACE procedure sessions were significantly higher in TACE+PSE group than that in TACE alone group (4.55 vs 3.26, P = 0.019). TACE+PSE group had longer median PFS (19.4 vs 9.5 months, P = 0.023) than TACE alone group, where PSE was an independent protective factor (HR, 0.508; P = 0.014). Initial and repeated PSE showed no significant differences in safety.
UNASSIGNED: Repeated PSE is effective in increasing PLT again and improving RBC, hemoglobin and liver function. It contributed to performing serial TACE procedures thereafter. TACE combined with repeated PSE has significantly longer PFS than TACE alone, where PSE was an independent protective factor. Moreover, the safety of repeated PSE was comparable to initial PSE.
UNASSIGNED: This retrospective study included 102 HCC patients with hypersplenism who received TACE (n = 73) or TACE+PSE (n = 29) from January 2014 to December 2021. Changes in peripheral blood cell and hepatic function were investigated at 1 week, 2, 6, 12, 18, and 24 months. TACE procedure sessions and adverse events were recorded. PFS and prognostic factors were analyzed.
UNASSIGNED: Despite response to initial PSE being limited, repeated PSE increased platelet (PLT) again, which peaked at 18 months. It also continued to improve red blood cell (RBC) and hemoglobin, which showed significant differences in changes from baseline between two groups until 24 months, as well as Child-Pugh scores at 12 and 18 months. Mean TACE procedure sessions were significantly higher in TACE+PSE group than that in TACE alone group (4.55 vs 3.26, P = 0.019). TACE+PSE group had longer median PFS (19.4 vs 9.5 months, P = 0.023) than TACE alone group, where PSE was an independent protective factor (HR, 0.508; P = 0.014). Initial and repeated PSE showed no significant differences in safety.
UNASSIGNED: Repeated PSE is effective in increasing PLT again and improving RBC, hemoglobin and liver function. It contributed to performing serial TACE procedures thereafter. TACE combined with repeated PSE has significantly longer PFS than TACE alone, where PSE was an independent protective factor. Moreover, the safety of repeated PSE was comparable to initial PSE.
摘要：
■部分脾栓塞术（PSE）联合经动脉化疗栓塞术（TACE）已被报道用于治疗肝硬化脾功能亢进和血小板减少症的肝细胞癌（HCC）。然而,需要时重复PSE的疗效和安全性尚不清楚。本研究旨在探讨外周血细胞和肝功能的术后变化，无进展生存期（PFS），与单独接受TACE相比,接受TACE和重复PSE的脾功能亢进HCC患者的安全性和安全性.
■这项回顾性研究纳入了102例于2014年1月至2021年12月接受TACE（n=73）或TACE+PSE（n=29）的脾功能亢进肝癌患者。在1周时调查外周血细胞和肝功能的变化，2、6、12、18和24个月。记录TACE程序和不良事件。分析PFS及预后因素。
■尽管对初始PSE的反应有限，反复PSE再次增加血小板（PLT），在18个月时达到顶峰。它还继续改善红细胞（RBC）和血红蛋白，这表明两组之间从基线到24个月的变化存在显着差异，以及12个月和18个月时的Child-Pugh评分。TACE+PSE组平均TACE疗程明显高于单纯TACE组(4.55vs3.26,P=0.019)。TACE+PSE组的中位PFS较长（19.4vs9.5个月，P=0.023)比单纯TACE组,其中PSE是一个独立的保护因素(HR，0.508；P=0.014）。初始和重复PSE在安全性方面没有显着差异。
■重复PSE对再次增加PLT和改善RBC有效，血红蛋白和肝功能。它有助于此后执行串行TACE程序。TACE合并反复PSE的PFS明显长于单独TACE,其中PSE是独立的保护因素。此外，重复PSE的安全性与初始PSE相当.
■这项回顾性研究纳入了102例于2014年1月至2021年12月接受TACE（n=73）或TACE+PSE（n=29）的脾功能亢进肝癌患者。在1周时调查外周血细胞和肝功能的变化，2、6、12、18和24个月。记录TACE程序和不良事件。分析PFS及预后因素。
■尽管对初始PSE的反应有限，反复PSE再次增加血小板（PLT），在18个月时达到顶峰。它还继续改善红细胞（RBC）和血红蛋白，这表明两组之间从基线到24个月的变化存在显着差异，以及12个月和18个月时的Child-Pugh评分。TACE+PSE组平均TACE疗程明显高于单纯TACE组(4.55vs3.26,P=0.019)。TACE+PSE组的中位PFS较长（19.4vs9.5个月，P=0.023)比单纯TACE组,其中PSE是一个独立的保护因素(HR，0.508；P=0.014）。初始和重复PSE在安全性方面没有显着差异。
■重复PSE对再次增加PLT和改善RBC有效，血红蛋白和肝功能。它有助于此后执行串行TACE程序。TACE合并反复PSE的PFS明显长于单独TACE,其中PSE是独立的保护因素。此外，重复PSE的安全性与初始PSE相当.
