Hepatosellüler Karsinomda İlaç Yüklenebilir Mikroküreler ile Yapılan Transarteriyel Kemoembolizasyonun Etkinliği: Tek Merkez Deneyimi

Year 2022, , 105 - 109, 30.08.2022

Gürkan Danışan , Erbil Arık

https://doi.org/10.18678/dtfd.1075822

Abstract

Amaç: Bu çalışmanın amacı hepatosellüler karsinomda (HCC) ilaç salınımlı mikroküreler ile yapılan transarteriyel kemoembolizasyon (TAKE) tedavisinin etkinliğini değerlendirmektir.
Gereç ve Yöntemler: 2019 ve 2021 tarihleri arasında ilaç salınımlı mikroküreler ile TAKE uygulanan 29 HCC'li hasta çalışmaya dahil edildi. TAKE işleminin başarısı işlem öncesi ve sonrası kontrastlı bilgisayarlı tomografi ve manyetik rezonans görüntüleri ile değerlendirildi. Hasta karakteristikleri, embolizasyon için kullanılan mikroküre boyutları, işleme bağlı komplikasyonlar ve işlem öncesi ve sonrası alfa fetoprotein (AFP) düzeyleri kaydedildi.
Bulgular: Hastaların yaş ortalaması 65,6±10,4 yıldı ve objektif yanıt oranı %17,2 (5/29) idi. 11 (%37,9) hastada 100-300 μm ve 18 (%62,1) hastada 300-500 μm boyutlarında partikül kullanılmıştı. Ortanca hedef lezyon sayısı 1 (aralık, 1-6) idi. Altı (%20,7) hastada hedef olmayan lezyon mevcuttu. Dört (%13,8) hastada yeni gelişen lezyon mevcuttu. İşlem sonrası ortanca hedef lezyon boyutunda (41; aralık, 0-116 mm) işlem öncesi (42; aralık, 22-188 mm) ile karşılaştırıldığında anlamlı bir azalma olduğu saptandı (p<0,001). Ayrıca, işlem öncesi (343; aralık, 1,44-2000 ng/mL) ve işlem sonrası (52; aralık, 0,95-1435 ng/mL) ortanca AFP değerleri arasında anlamlı bir farklılık saptandı (p<0.001).
Sonuç: HCC hastalarının büyük bir kısmı intermediate evrede teşhis edildiğinden küratif tedavileri mümkün değildir. Bu hasta grubunda TAKE, hastalığın lokal kontrolünde önemli bir tedavi seçeneğidir. Bununla birlikte, TAKE tedavisinin başarısı kanser evresi, hasta sayısı, takip süresi ve kullanılan mikrokürenin tipi ve boyutuna göre değişkenlik gösterebilir.

Keywords

Hepatosellüler karsinom, transarteriyel kemoembolizasyon, ilaç salınımlı mikroküreler

Efficacy of Transarterial Chemoembolization with Drug-Eluting Beads in Hepatocellular Carcinoma: A Single-Center Experience

Abstract

Aim: The aim of this study was to evaluate the efficacy of transarterial chemoembolization (TACE) with drug-eluting beads in hepatocellular carcinoma (HCC).
Material and Methods: Twenty-nine patients with HCC who were treated with TACE with drug-eluting beads between 2019 and 2021 were included in the study. The success of the TACE procedure was evaluated using pre- and post-operative contrast-enhanced computed tomography/magnetic resonance images. Patient characteristics, embolizing-bead sizes, procedure-related complications, and pre- and post-procedure alpha-fetoprotein (AFP) levels were recorded.
Results: The mean age of the patients was 65.6±10.4 years, and the objective response rate was 17.2% (5/29). 100-300 μm particles were used in 11 (37.9%) patients, and 300-500 μm particles were used in 18 (62.1%). The median target lesion number was 1 (range, 1-6). Six (20.7%) patients had non-target lesions. There were newly developed lesions in four (13.8%) patients. A significant decrease was found in the median target lesion size after (41; range, 0-116 mm) the procedure compared to the pre- (42; range, 22-188 mm) procedure (p<0.001). A significant difference was found between the median AFP levels before (343; range, 1.44-2000 ng/mL) and after (52; range, 0.95-1435 ng/mL) the procedure (p<0.001).
Conclusion: Since most patients with HCC are diagnosed in the intermediate stage, curative treatment is not possible. TACE is an important treatment option for the local control of the disease in this patient group. However, the success of TACE treatment may vary depending on the cancer stage, number of patients, follow-up period, and type and size of the microsphere used.

Keywords

: hepatocellular carcinoma, transarterial chemoembolization, drug-eluting beads

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