■这项研究的目的是报告通过肝内动脉联合经动脉放射栓塞(TARE)和通过肝外供血动脉(EHFA)联合经动脉化疗栓塞(TACE)的安全性和肿瘤反应率肝细胞癌(HCC)。
■肝癌患者,在介入前多相CT上可见肝内和肝外动脉供应,并在2016年至2021年之间对同一结节进行TACE和TARE联合治疗,被回顾性地包括在内。流行病学,临床,生物,并记录了放射学特征。在6个月时评估安全性和肿瘤反应。
■9名患者(8名男性,中位年龄62岁[IQR:54-72岁])。7名患者先前对目标结节进行过治疗(TARE:5;TACE:2)。病变的中长轴(LA)为70mm(IQR:60-79mm)。3例患者有门静脉侵犯(VP3)。EHFA起源于右膈动脉(n=6),右肾上腺动脉(n=2),胃左动脉(n=1)。用TACE处理的肿瘤部分的LA为47mm(范围:35-64mm)。整个病变的LA与用TACE治疗的LA之间的比率为1.44(范围:1.27-1.7)。发生了一种主要并发症:慢性急性肝衰竭。中位随访时间为23个月(范围:16-29个月)。7例患者接受了进一步治疗:在同一病变上(n=2),在新出现的结节(n=2)上,和全身治疗(n=3)。在6个月的随访中,7例患者表现出局部客观反应.进展时间为13(3.5-19)个月。
■TARE和肝外TACE联合治疗肝癌,肝内和肝外动脉供应似乎是可行和安全的。需要进一步的研究来验证这些初步结果的有效性。
UNASSIGNED: The aim of this study was to report the safety and tumor response rate of combined transarterial radioembolization (TARE) through the intrahepatic arteries and transarterial chemoembolization (
TACE) through the extrahepatic feeding arteries (EHFA) in patients with hepatocellular carcinoma (HCC).
UNASSIGNED: Patients with HCC, who had both intrahepatic and extrahepatic arterial supply visible on preinterventional multiphase CT and were treated between 2016 and 2021 with a combination of
TACE and TARE on the same nodule, were retrospectively included. Epidemiological, clinical, biological, and radiological characteristics were recorded. Safety and tumor response were assessed at 6 months.
UNASSIGNED: Nine patients (8 men, median age 62 years [IQR: 54-72 years]) were included. Seven patients had previous treatments on the target nodule (TARE: 5;
TACE: 2). The median longest axis (LA) of the lesion was 70 mm (IQR: 60-79 mm). Three patients had portal vein invasion (VP3). The EHFA originated from the right diaphragmatic artery (n = 6), the right adrenal artery (n = 2), and the left gastric artery (n = 1). The LA of the tumor portion treated with
TACE was 47 mm (range: 35-64 mm). The ratio between the LA of the entire lesion and the LA treated with
TACE was 1.44 (range: 1.27-1.7). One major complication occurred: acute on chronic liver failure. Median follow-up was 23 months (range: 16-29 months). Seven patients underwent further treatment: on the same lesion (n = 2), on newly appeared nodules (n = 2), and systemic treatment (n = 3). At 6-month follow-up, seven patients showed a local objective response. Time-to-progression was 13 (3.5-19) months.
UNASSIGNED: The combination of TARE and extrahepatic TACE for HCC with both intrahepatic and extrahepatic arterial supplies seems feasible and safe. Further studies are needed to validate the effectiveness of these preliminary results.