Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Dec 15, 2022; 14(12): 2367-2379
Published online Dec 15, 2022. doi: 10.4251/wjgo.v14.i12.2367
Evaluation of short-term effects of drug-loaded microspheres and traditional transcatheter arterial chemoembolization in the treatment of advanced liver cancer
Ting Ye, Shi-Han Shao, Kan Ji, Shu-Lin Yao
Ting Ye, Shu-Lin Yao, Department of Nuclear Medicine, First Medical Center, PLA General Hospital, Beijing 100039, China
Shi-Han Shao, Department of Hepatobiliary Surgery, The Sixth Medical Center, PLA General Hospital, Beijing 100048, China
Kan Ji, Department of Interventional Radiology, First Medical Center, PLA General Hospital, Beijing 100071, China
Author contributions: Ye T contributed to the research design and thesis writing; Shao SH collected and analyzed the data; Ji K contributed to the data collection; Yao SL overall supervise the study; and all authors proofed the revised manuscript.
Supported by National key research and development project of Ministry of Science and Technology, No. 2016YFC0103908.
Institutional review board statement: This study was approved by the First Medical Center, PLA General Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: No conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shu-Lin Yao, MD, Associate Chief Technician, Statistical Worker, Department of Nuclear Medicine, First Medical Center, PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100039, China. yaoshulinvip@126.com
Received: August 1, 2022
Peer-review started: August 1, 2022
First decision: August 21, 2022
Revised: August 29, 2022
Accepted: November 16, 2022
Article in press: November 16, 2022
Published online: December 15, 2022
Processing time: 132 Days and 20.5 Hours
Abstract
BACKGROUND

Liver cancer is a malignant tumor with high morbidity and mortality. Transcatheter arterial chemoembolization (TACE) is the main method for surgically unresectable liver cancer. In recent years, drug-loaded microspheres have been gradually applied in TACE technology. There are some controversies about the therapeutic effects of drug-loaded microspheres TACE (D-TACE) and traditional TACE.

AIM

To explore the short-term efficacy of D-TACE and traditional TACE in the treatment of advanced liver cancer.

METHODS

The clinical data of 73 patients with advanced liver cancer admitted to the First and Sixth Medical Centers of Chinese PLA General Hospital from January 2017 to October 2019 were retrospectively analyzed. Among them, 15 patients were treated with D-TACE, and 58 patients were treated with traditional TACE. Clinical baseline characteristics, perioperative laboratory indices, postoperative adverse reactions and postoperative complications were compared between the two groups.

RESULTS

There was no statistical difference between the two groups for the postoperative response: The highest postoperative body temperature of the drug-loaded microsphere group was 38.0 ± 0.9℃ and the postoperative highest body temperature of the traditional TACE group was 38.3 ± 0.7℃ (t = -1.414, P = 0.162). For the 24 h postoperative nausea and vomiting after surgery in terms of scoring and postoperative pain scores, the traditional TACE group was higher than the drug-loaded microsphere group (χ2 = 14.33, P = 0.014; χ2 = 32.967, P = 0.000) and the two groups had significant statistical differences. The disease control rate at 3 mo after treatment in the drug-loaded microsphere group was 60% and the disease control rate at 3 mo after treatment in the traditional TACE group was 75.9% (χ2 = 4.091, P = 0.252). There was no statistical difference between the two groups of data. During the follow-up period, the number of interventional treatments received was once in the drug-loaded microsphere group and the traditional TACE group received an average of 1.48 treatments (χ2 = 10.444 P = 0.005). There was a statistical difference between the two groups.

CONCLUSION

Compared with traditional TACE, D-TACE may have some advantages in the treatment of advanced hepatocellular carcinoma with a large tumor load in the short term, but the long-term clinical efficacy needs additional follow-up studies. In addition, compared with the traditional group, the patients in the drug-loaded microsphere group had better subjective tolerance and could reduce the number of interventional treatments. Therefore, D-TACE is worthy of clinical promotion.

Keywords: Primary liver cancer; Hepatocellular carcinoma; Drug-loaded microsphere transcatheter arterial chemoembolization; Traditional transcatheter arterial chemoembolization; Treatment; Short-term efficacy

Core Tip: Hepatocellular carcinoma with a very high mortality rate is insidious and about 80 per cent of patients have no chance of surgery when diagnosed. Transcatheter arterial chemoembolization (TACE) is recommended as a first-line treatment. Traditional TACE uses iodized oil and gelatin sponge as the main embolization materials, and the chemotherapeutic drugs are mixed with iodized oil and injected into the tumor feeding artery to achieve the dual role of embolization and chemotherapy. Some scholars believe that liver cancer cells are not sensitive to chemotherapy drugs, so the role of chemotherapy drugs in TACE treatment is controversial. In recent years, drug-loaded microspheres have been gradually applied in TACE technology, which can significantly improve the killing effect of drugs on tumor tissues, and significantly reduce the systemic drug concentration, thereby reducing the side effects of chemotherapy drugs. In this study, the effects of using the same size of embolization particles and drug-eluting beads during TACE were compared. To investigate the effect and systemic response of chemotherapy drugs in TACE under the new local drug delivery mode.