Clinical efficacy analysis of DEB-TACE compared with traditional TACE in treatment of patients with different BCLC stages of liver cancer
Objective To compare the clinical efficacy of CalliSpheres drug-loaded microspheres bead-transcatheter arterial chemoembolization(DEB-TACE)and transcatheter arferial chemoembolization(TACE)in treatment of patients with different stages of Barcelona clinic liver cancer(BCLC).Methods From December 2018 to December 2020,a total of 102 BCLC patients were enrolled,which included 75 males and 27 females,aged 41-75 years old with mean age of 57.85 years old;body mass index(BMI)was 18.2-26.7 kg/m2 with mean BMI of 22.58 kg/m2.According to Child-Pugh classification,there were 53 cases of grade A and 49 of grade B;the tumor diameter was 4-13 cm with mean tumor diameter of 8.22 cm;52 cases of BCLC stage A and 50 of stage B.According to random number table method,all of them were divided into ob-servation group and control group in ratio of 1∶1,with 51 cases in each group.The control group was performed with tradi-tional TACE,and observation group with DEB-TACE.The clinical efficacy,tumor marker levels[a-L-fucosidase(AFU),car-cinoembryonic antigen(CEA),alpha-fetoprotein(AFP)],liver function[alanine aminotransferase(ALT),aspartate aminotrans-ferase(AST)],serum Golgi protein 73(GP73),Dickkopf-1(DKK1),thymidine kinase 1(TK1)levels,and incidence of compli-cations before and 3-month after treatment,the 6-month and 12-month survival rate were compared between 2 group with different BCLC stages.Results The disease control rate of stage B patients in observation group(79.17％)was higher than that in control group(50.00％)(P＜0.05);at 3-month after treatment,the serum levels of AFP,CEA,AFU,GP73,DKK1 and TK1 in observation group were lower than those in control group[(96.85±8.20)pg/L vs(106.73±7.96)pg/L,(17.57±2.69)μg/L vs(19.93±3.08)μg/L,(48.26±6.48)U/L vs(54.22±8.02)U/L;P＜0.05.(89.63±11.25)μg/L vs(98.48±13.26)pg/L,(2.72±0.61)μg/L vs(3.26±0.75)μg/L,(4.27±0.95)pmol/L vs(5.03±1.08)pmol/L.P＜0.05];the levels of serum ALT and AST of patients with stage A and B in observation group were lower than those in control group 3-month after treatment[stage A:(40.32±9.25)U/L vs(46.86±11.17)U/L,(52.69±7.65)U/L vs(59.78±8.77)U/L;stage B:(49.27±10.33)U/L vs(56.75±9.68)U/L,(65.07±10.76)U/L vs(73.15±13.53)U/L.P＜0.05];the incidence of liver function injury in observation group was lower than that in control group(3.92％vs 17.65％.P＜0.05).There was no significant difference in 6-month survival rate between 2 groups(P＞0.05),but 12-month survival rate of observation group was significantly higher than that of control group(78.43％vs 58.82％.P＜0.05).There was no significant difference in disease control rate,serum levels of AFP,CEA,AFU,GP73,DKK1 and TKl after treatment for 3-month between 2 groups of BCLC patients with stage A(P＞0.05).Conclusion It is demonstrated that for BCLC patients with stage A,traditional TACE and DEB-TACE showed similar therapeutic effects,but could significantly reduce liver function damage;For BCLC patients with stage B,DEB-TACE treatment could significantly improve efficacy,and show more advantages in reducing tumor markers and liver injury,regulating serum levels of GP73,DKK1,TK1,and prolonging survival time.
Barcelona clinic liver cancer stagingCalliSpheres drug-loaded microspheresliver cancerarterial chemoembolizationefficacy
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