Abstract：
OBJECTIVE: To compare oncologic outcomes of transarterial chemoembolization (TACE) using 70-150 μm and 100-300 μm drug-eluting beads (DEBs) to treat small hepatocellular carcinoma (HCC).
METHODS: This retrospective study included 93 patients with small HCC (≤3cm) who underwent first TACE with DEB: 43 with 70-150 μm DEBs and 50 with 100-300 μm DEBs. Initial tumor response was assessed using per-patient and per-lesion analysis. Progression-free survival (PFS) and target tumor PFS were analyzed for patients and lesions with initial complete response (CR). Overall survival (OS) and safety outcomes were also evaluated.
RESULTS: At 1 month, initial CR rates were 72.1% in the 70-150 μm group and 70.0% in the 100-300 μm group. PFS was significantly longer in the 70-150 μm group (median, 26 months) compared with the 100-300 μm group (median, 11 months; log-rank p=0.049), with comparable OS results (p=0.096). Per-lesion analysis found that target tumor PFS was significantly longer in the 70-150 μm group (median, 30 months) compared with the 100-300 μm group (median, 13 months; p=0.009). Subgroup analysis revealed the 70-150 μm group had significantly longer target tumor PFS compared with the 100-300 μm group in the 1.0-2.0 cm subgroup (p=0.017), but not in the 2.1-3.0 cm subgroup (p=0.117). No significant differences in adverse events were observed between the two groups.
CONCLUSIONS: The 70-150 μm and 100-300 μm DEB-TACE resulted in comparable tumor response and short-term safety in small HCCs (≤3cm). However, in cases where CR was achieved, treatment with smaller beads demonstrated longer PFS and target tumor PFS.
METHODS: This retrospective study included 93 patients with small HCC (≤3cm) who underwent first TACE with DEB: 43 with 70-150 μm DEBs and 50 with 100-300 μm DEBs. Initial tumor response was assessed using per-patient and per-lesion analysis. Progression-free survival (PFS) and target tumor PFS were analyzed for patients and lesions with initial complete response (CR). Overall survival (OS) and safety outcomes were also evaluated.
RESULTS: At 1 month, initial CR rates were 72.1% in the 70-150 μm group and 70.0% in the 100-300 μm group. PFS was significantly longer in the 70-150 μm group (median, 26 months) compared with the 100-300 μm group (median, 11 months; log-rank p=0.049), with comparable OS results (p=0.096). Per-lesion analysis found that target tumor PFS was significantly longer in the 70-150 μm group (median, 30 months) compared with the 100-300 μm group (median, 13 months; p=0.009). Subgroup analysis revealed the 70-150 μm group had significantly longer target tumor PFS compared with the 100-300 μm group in the 1.0-2.0 cm subgroup (p=0.017), but not in the 2.1-3.0 cm subgroup (p=0.117). No significant differences in adverse events were observed between the two groups.
CONCLUSIONS: The 70-150 μm and 100-300 μm DEB-TACE resulted in comparable tumor response and short-term safety in small HCCs (≤3cm). However, in cases where CR was achieved, treatment with smaller beads demonstrated longer PFS and target tumor PFS.
摘要：
目的：比较使用70-150μm和100-300μm药物洗脱珠（DEB）的经动脉化疗栓塞（TACE）治疗小肝癌（HCC）的肿瘤学结果。
方法：这项回顾性研究包括93例小肝癌（≤3cm）患者，这些患者接受了首次TACE治疗，其中DEB：43例接受70-150μmDEB，50例接受100-300μmDEB。使用每个患者和每个病变分析评估初始肿瘤反应。分析患者和具有初始完全缓解(CR)的病变的无进展生存期(PFS)和靶肿瘤PFS。还评估了总生存期（OS）和安全性结果。
结果：在1个月时，初始CR率在70-150μm组为72.1％，在100-300μm组为70.0％。70-150μm组的PFS明显更长（中位数，26个月）与100-300μm组（中位数，11个月；对数秩p=0.049)，具有可比的OS结果（p=0.096）。每个病变分析发现，70-150μm组的靶肿瘤PFS明显更长（中位数，30个月）与100-300μm组（中位数，13个月；p=0.009）。亚组分析显示，与1.0-2.0cm亚组的100-300μm组相比，70-150μm组的靶肿瘤PFS明显更长（p=0.017），但不在2.1-3.0厘米亚组（p=0.117）。两组间不良事件无显著差异。
结论：在小肝癌（≤3cm）中，70-150μm和100-300μmDEB-TACE可产生相当的肿瘤反应和短期安全性。然而,在实现CR的情况下，用较小的珠子治疗显示较长的PFS和靶肿瘤PFS。
方法：这项回顾性研究包括93例小肝癌（≤3cm）患者，这些患者接受了首次TACE治疗，其中DEB：43例接受70-150μmDEB，50例接受100-300μmDEB。使用每个患者和每个病变分析评估初始肿瘤反应。分析患者和具有初始完全缓解(CR)的病变的无进展生存期(PFS)和靶肿瘤PFS。还评估了总生存期（OS）和安全性结果。
结果：在1个月时，初始CR率在70-150μm组为72.1％，在100-300μm组为70.0％。70-150μm组的PFS明显更长（中位数，26个月）与100-300μm组（中位数，11个月；对数秩p=0.049)，具有可比的OS结果（p=0.096）。每个病变分析发现，70-150μm组的靶肿瘤PFS明显更长（中位数，30个月）与100-300μm组（中位数，13个月；p=0.009）。亚组分析显示，与1.0-2.0cm亚组的100-300μm组相比，70-150μm组的靶肿瘤PFS明显更长（p=0.017），但不在2.1-3.0厘米亚组（p=0.117）。两组间不良事件无显著差异。
结论：在小肝癌（≤3cm）中，70-150μm和100-300μmDEB-TACE可产生相当的肿瘤反应和短期安全性。然而,在实现CR的情况下，用较小的珠子治疗显示较长的PFS和靶肿瘤PFS。
