为什么选择载药微球DEB治疗转移性肝癌的适应症 D-TACE结果 并发症
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DEB-TACE 结直肠肝转移癌适应症

时间:2020-12-14 23:15来源:未知 作者:Mr.Editor
药物洗脱微球栓塞治疗肝转移癌的适应症 Indications for DEB 不可切除的肝转移病变Non-resectable disease 热消融技术不能完全治疗的肝转移病变 Not completely treatable with thermal ablative techniques 病变累积肝脏<70%的肝转移病变 70% liver involv

药物洗脱微球栓塞治疗肝转移癌的适应症
Indications for DEB
 

 
  • 不可切除的肝转移病变Non-resectable disease
            1)一线,二线全身化疗后肝内病变进展=拯救性治疗 Hepatic PD after 1st-, 2nd,+ -line systemic trx. „salvage patients“
 
            2)降期治疗或转化治疗 (transmission therapy)到切除

            3)肝内病变为主的病变巩固治疗
 
  • 热消融技术不能完全治疗的肝转移病变 Not completely treatable with thermal ablative techniques
 
  • 病变累积肝脏<70%的肝转移病变 < 70% liver involvement
 
  • 肝为主的病变 Liver dominant disease
 
  • 肝功能良好 Adequate synthetic liver function
 
  • 体力评分 0-1分  Performance status ECOG 0-1

拯救性患者的 D-TACE(DE-TACE in Salvage Patients)


study design pts. strategy oRR (%) mOS mo PFS mo
Fiorentini 2007 retrosp. 20 salvage 80 (?) n.r. n.r.
Martin 2009 retrosp. 55 salvage 41 mRECIST
6 RECIST
11 8
Narayanan 2013 retrosp. 28 salvage 45 mRECIST 13.3 4
Huppert 2013 prosp. 29 salvage 72 mRECIST
0 RECIST
8 5
Iezzi 2015 retrosp. 20 salvage 10 RECIST 7.3 4.0

 

 

 

 

 

 

 
cTACE
 

 

 

 
8-14 3-8

DE-TACE in Salvage Patients
 
Outcome in Salvage Patients


降期切除 (Downstaging to Resection)


study design pts. oRR (%) mOS
mo
PFS
mo
Downstaging to
resection
Martin 2009 retrosp. 55 41 mRECIST
6 RECIST
11 8 6/55 (10%)
Akinwande 2016 prosp. 15 73 mRECIST
33 RECIST
13 8 2/15 (13%)


Consolidation in Liver dominant disease

study design pts. strategy oRR (%) mOS mo PFS mo
Martin 2015 prosp. 30 FOLFOX various 60 mRECIST n.a. 7.6
30 FOLFOX
+ DEBIRI
76
 
15.3



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