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Volume 40 Issue 12
Dec.  2024
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Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(12): 2457-2463

Efficacy of drug-eluting beads-transarterial chemoembolization combined with infusion chemotherapy via superior mesenteric artery in treatment of hepatocellular carcinoma complicated by portal vein tumor thrombus

DOI: 10.12449/JCH241216

  • Department of Interventional Radiology，The Affiliated Hospital of Xuzhou Medical University，Xuzhou，Jiangsu 221006，China

Research funding:

Jiangsu Medical Association Interventional Medicine Second Phase Research Special Funds Project (SYH-3201140-0052)

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  • Corresponding author: ZHANG Qingqiao， 1427286069@qq.com （ORCID： 0000-0001-6177-7081）
  • Received Date: 2024-04-14
  • Accepted Date: 2024-07-08
  • Published Date: 2024-12-25
    Abstract
  •   Objective  To investigate the efficacy of drug-eluting beads-transarterial chemoembolization （D-TACE） combined with infusion chemotherapy via superior mesenteric artery versus D-TACE alone in the treatment of hepatocellular carcinoma （HCC） complicated by portal vein tumor thrombus （PVTT）.  Methods  A retrospective analysis was performed for the data of patients with HCC and PVTT who underwent interventional treatment in The Affiliated Hospital of Xuzhou Medical University from January 2022 to December 2023， among whom 15 patients received D-TACE combined with infusion chemotherapy via superior mesenteric artery and were enrolled as observation group， and after propensity score matching at a ratio of 1∶1， 15 patients who received D-TACE alone were enrolled as control group. Contrast-enhanced MRI of the upper abdomen was performed at 1， 2， and 3 months after surgery and every 3 months thereafter to evaluate the conditions of liver tumor and PVTT. Objective response rate （ORR） and disease control rate （DCR） were compared between the two groups. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the paired t-test or the Wilcoxon test was used for comparison of preoperative and postoperative data； the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier curve was used to calculate the cumulative survival rate， and the Log-rank test was used for comparison between two groups.  Results  Both groups had a technical success rate of 100%， with no serious complications after surgery. The patients were followed up for 3-26 months （mean 10.5±6.7 months）. At 3 months after surgery， there were no significant differences between the observation group and the control group in ORR （73.3% vs 53.3%， χ2=1.292， P=0.256） and DCR （93.3% vs 80.0%， χ2=1.154， P=0.283） for liver tumors， and compared with the control group， the observation group had significantly higher ORR and DCR for PVTT （ORR： 46.7% vs 13.3%， χ2=3.968， P=0.046； DCR： 100% vs 73.3%， χ2=4.615， P=0.032）. The 3-， 6-， and 12-month cumulative progression-free survival rates were 93.3%， 86.2%， and 68.9%， respectively， for the observation group and were 80.0%， 62.2%， and 24.9%， respectively， for the control group （P=0.028）， and the 3-， 6-， and 12-month cumulative overall survival rates were 100%， 88.9%， and 88.9%， respectively， for the observation group and were 93.3%， 85.6%， and 70.0%， respectively， for the control group （P=0.340）.  Conclusion  Compared with D-TACE alone， D-TACE combined with infusion chemotherapy via the superior mesenteric artery shows better short-term efficacy in the treatment of HCC complicated by PVTT.

     

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