经导管动脉化疗栓塞术治疗局部复发乳腺癌的疗效与安全性
Efficacy and safety of transcatheter arterial chemoembolization for the treatment of locally recurrent breast cancer
余磊 1邹春峰 2苏孙欢 1张诚琮 1曹志伟 1张起楷 1陈丽红1
作者信息
- 1. 365000 福建三明 福建医科大学附属三明第一医院介入科
- 2. 福建省三明市清流县总医院介入放射科
- 折叠
摘要
目的 探讨经导管动脉化疗栓塞术治疗局部复发乳腺癌的疗效与安全性.方法 回顾性分析2018年1月至2020年12月复发乳腺癌患者57例,接受经导管动脉化疗栓塞术治疗24例为A组,化疗药物为多柔比星12 mg/m2、紫杉醇45 mg/m2,化疗药物采用微导管于肿瘤靶血管局部灌注方式完成,靶血管栓塞材料为Embosphere栓塞微球,栓塞终点为肿瘤靶血管主干闭塞.选择同时段全身化疗患者33例为B组,化疗药物为多柔比星40 mg/m2、紫杉醇135 mg/m2,比较两组间6个月疾病控制率、无进展生存时间、总体生存时间差异.结果 A组24例患者均成功实施经导管动脉化疗栓塞术,技术成功率100％,6个月疾病控制率87.50％,中位无疾病进展生存期(PFS)12个月,中位总生存期(OS)22个月;B组6个月疾病控制率63.63％,PFS 9个月,中位OS 20个月;两组间6个月疾病控制率、中位无疾病进展生存期差异有统计学意义(P=0.04,P=0.03),两组间中位总生存期差异无统计学意义(P=0.21);A组患者栓塞术后综合征发生率为75％(18/24),胸壁疼痛、低热经止痛、退热等对症治疗3d后症状消失,所有患者未出现经导管动脉栓塞术相关靶血管损伤、栓塞剂异位栓塞、胸壁坏死等严重并发症.术后随访时间为(19.47±4.96)个月(8～24个月).结论 经导管动脉化疗栓塞术治疗局部复发乳腺癌近期疗效优于全身化疗,未发生介入相关严重并发症,其远期疗效及安全性有待更多病例证实.
Abstract
Objective To investigate the efficacy and safety of transcatheter arterial chemoembolization(TACE)for the treatment of locally recurrent breast cancer.Methods The clinical data of 57 patients with locally recurrent breast cancer from January 2018 to December 2020 were retrospectively analyzed.Twenty-four patients(group A)received TACE using adriamycin 12 mg/m2 and paclitaxel 45 mg/m2,which was accomplished by local perfusion into the tumor target blood vessels with microcatheter catheterization,the embolization material was Embosphere microspheres,and the embolization endpoint was occlusion of the main stem of the target vessel.Other 33 patients who received systemic chemotherapy using adriamycin 40 mg/m2 and paclitaxel 135 mg/m2 in the same period were collected as group B.The 6-month disease control rate(DCR),progression-free survival(PFS)and overall survival(OS)were compared between the two groups.Results Successful TACE was accomplished in all the 24 patients of group A,with a technical success rate of 100％.In group A,the 6-month DCR was 87.50％,the median PFS was 12 months,and the median OS was 22 months.In group B,the 6-month DCR was 63.63％,the median PFS was 9 months,and the median OS was 20 months.The differences in the 6-month DCR and the median PFS between the two groups were statistically significant(P=0.04 and P=0.03 respectively),while no statistically significant difference in the median OS existed between the two groups(P=0.21).The incidence of post-embolization syndrome in group A was 75％(18/24),the clinical symptoms included chest wall pain and mild fever,which disappeared 3 days after symptomatic treatment such as pain-relief and antipyretic medication,and no TACE-related serious complications such as target vessel injury,ectopic embolization of embolization materials or chest wall necrosis occurred in all patients.All patients were followed up for a mean period of(19.47±4.96)months(range of 8-24 months)Conclusion For the treatment of locally recurrent breast cancer,TACE is superior to systemic chemotherapy in short-term efficacy.TACE carries no intervention-related serious complications.However,more studies need to be conducted before its long-term efficacy and safety can be clarified.(J Intervent Radiol,2024,33:280-284)
关键词
经导管动脉化疗栓塞术/局部复发乳腺癌/疗效/安全性Key words
transcatheter arterial chemoembolization/locally recurrent breast cancer/efficacy/safety引用本文复制引用
出版年
2024
NETL
NSTL
万方数据