内容紹介
Summary
We previously reported that the antitumor response of balloon-occluded transcatheter arterial chemoembolization(B-TACE)is better than that of conventional transcatheter arterial chemoembolization(C-TACE). Thus far, little attention has been paid on the efficacy of B-TACE using the same antitumor agents for hepatocellular carcinoma(HCC)that is unresponsive to C-TACE, which is defined as ≤50% necrosis of the targeted nodules or the appearance of new lesions in the liver 1-3 months following one C-TACE procedure. Therefore, this study focused on the efficacy of B-TACE using the same antitumor agents for HCC that is unresponsive to C-TACE. Fourteen patients treated with B-TACE at our institution were retrospectively investigated between January 2011 and August 2015. The median age was 76(interquartile range[IQR]70-79)years, and 9 patients(64.3%)were men. A total of 9(64.3%)and 5(35.7%)patients had the Child-Pugh class A and B, respectively. The median maximum tumor diameter was 30(IQR 18-40)mm, and 4(28.6%), 3(21.4%), 0(0.0%), and 7(50.0%)patients had 1, 2, 3, and ≥4 tumors, respectively. The antitumor effects were CR, PR, SD, and PD in 6(42.9%), 1(7.1%), 3(21.4%), and 7(28.6%)patients, respectively. The response and disease control rates were 50% and 71.4%, respectively. Our results suggest that B-TACE is an effective modality for the treatment of HCC that is unresponsive to C-TACE.
要旨
われわれはballoon-occluded transcatheter arterial chemoembolization(B-TACE)のほうが,conventional transcatheter arterial chemoembolization(C-TACE)と比較して標的結節の抗腫瘍効果は良好であることを報告してきた。しかし前治療のC-TACEで反応しない症例に対して,同じ薬剤を使用してB-TACEを行った症例の治療効果は検討されていない。2011年1月～2015年8月までに,当科で前治療C-TACEで反応しない症例に対するB-TACEを行ったのは14例であった。なお,「前治療C-TACEに反応しない」の定義は,C-TACEを1回実施後の1～3か月後の画像評価で標的結節の壊死率≦50%,または肝内に新規病変の出現とした。年齢中央値は76(70～79)歳で,男性は9例(64.3%)であった。肝機能は,Child-Pugh分類A/Bがそれぞれ9例(64.3%)/5例(35.7%)であった。最大腫瘍径の中央値は30(四分位18～40)mmで,治療前の腫瘍個数は,1個が4例(28.6%),2個が3例(21.4%),3個が0例(0.0%),4個以上が7例(50.0%)であった。抗腫瘍効果は,complete response(CR)が6例(42.9%),partial response(PR)が1例(7.1%),stable disease(SD)が3例(21.4%),progressive disease(PD)が4例(28.6%)で,奏効率は50.0%,病勢コントロール率が71.4%であった。C-TACEで反応しない肝細胞癌(HCC)患者に対するB-TACEは有効である可能性が示唆された。
目次
癌と化学療法 TOPへ
癌と化学療法 45巻9号 2018年9月号トップへ
【原著】
▶前治療Conventional Transcatheter Arterial Chemoembolization(C-TACE)に反応しない肝細胞癌症例に対してBalloon-Occluded Transcatheter Arterial Chemoembolization(B-TACE)は有効か? 畑中 健ほか
We previously reported that the antitumor response of balloon-occluded transcatheter arterial chemoembolization(B-TACE)is better than that of conventional transcatheter arterial chemoembolization(C-TACE). Thus far, little attention has been paid on the efficacy of B-TACE using the same antitumor agents for hepatocellular carcinoma(HCC)that is unresponsive to C-TACE, which is defined as ≤50% necrosis of the targeted nodules or the appearance of new lesions in the liver 1-3 months following one C-TACE procedure. Therefore, this study focused on the efficacy of B-TACE using the same antitumor agents for HCC that is unresponsive to C-TACE. Fourteen patients treated with B-TACE at our institution were retrospectively investigated between January 2011 and August 2015. The median age was 76(interquartile range[IQR]70-79)years, and 9 patients(64.3%)were men. A total of 9(64.3%)and 5(35.7%)patients had the Child-Pugh class A and B, respectively. The median maximum tumor diameter was 30(IQR 18-40)mm, and 4(28.6%), 3(21.4%), 0(0.0%), and 7(50.0%)patients had 1, 2, 3, and ≥4 tumors, respectively. The antitumor effects were CR, PR, SD, and PD in 6(42.9%), 1(7.1%), 3(21.4%), and 7(28.6%)patients, respectively. The response and disease control rates were 50% and 71.4%, respectively. Our results suggest that B-TACE is an effective modality for the treatment of HCC that is unresponsive to C-TACE.
要旨
われわれはballoon-occluded transcatheter arterial chemoembolization(B-TACE)のほうが,conventional transcatheter arterial chemoembolization(C-TACE)と比較して標的結節の抗腫瘍効果は良好であることを報告してきた。しかし前治療のC-TACEで反応しない症例に対して,同じ薬剤を使用してB-TACEを行った症例の治療効果は検討されていない。2011年1月～2015年8月までに,当科で前治療C-TACEで反応しない症例に対するB-TACEを行ったのは14例であった。なお,「前治療C-TACEに反応しない」の定義は,C-TACEを1回実施後の1～3か月後の画像評価で標的結節の壊死率≦50%,または肝内に新規病変の出現とした。年齢中央値は76(70～79)歳で,男性は9例(64.3%)であった。肝機能は,Child-Pugh分類A/Bがそれぞれ9例(64.3%)/5例(35.7%)であった。最大腫瘍径の中央値は30(四分位18～40)mmで,治療前の腫瘍個数は,1個が4例(28.6%),2個が3例(21.4%),3個が0例(0.0%),4個以上が7例(50.0%)であった。抗腫瘍効果は,complete response(CR)が6例(42.9%),partial response(PR)が1例(7.1%),stable disease(SD)が3例(21.4%),progressive disease(PD)が4例(28.6%)で,奏効率は50.0%,病勢コントロール率が71.4%であった。C-TACEで反応しない肝細胞癌(HCC)患者に対するB-TACEは有効である可能性が示唆された。