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Clinical study of different interventional treatments for primary hepatocellular carcinoma based on propensity-score matching. | LitMetric

AI Article Synopsis

  • Transcatheter arterial chemoembolization (TACE) is a key treatment for patients with primary hepatocellular carcinoma (PHC) who cannot have surgery, with two types: conventional TACE (c-TACE) and drug-eluting bead TACE (DEB-TACE), each having different characteristics that affect their effectiveness.
  • A study analyzed outcomes of DEB-TACE and c-TACE in PHC patients, using propensity-score matching to ensure balanced comparison, with 86 patients in each group after matching.
  • Results showed DEB-TACE had better clinical efficacy, with higher objective response and disease control rates, as well as improved liver function post-treatment, indicating it may be a more effective option for treating PHC

Article Abstract

Background: Transcatheter arterial chemoembolization (TACE) is the main treatment for patients with primary hepatocellular carcinoma (PHC) who miss the opportunity to undergo surgery. Conventional TACE (c-TACE) uses iodized oil as an embolic agent, which is easily washed by blood and affects its efficacy. Drug-eluting bead TACE (DEB-TACE) can sustainably release chemotherapeutic drugs and has a long embolization time. However, the clinical characteristics of patients before the two types of interventional therapies may differ, possibly affecting the conclusion. Only a few studies have compared these two interventions using propensity-score matching (PSM).

Aim: To analyze the clinical effects of DEB-TACE and c-TACE on patients with PHC based on PSM.

Methods: Patients with PHC admitted to Dangyang People's Hospital (March 2020 to March 2024) were retrospectively enrolled and categorized into groups A (DEB-TACE, = 125) and B (c-TACE, = 106). Sex, age, Child-Pugh grade, tumor-node-metastasis stage, and Eastern Cooperative Oncology Group score were selected for 1:1 PSM. Eighty-six patients each were included post-matching. Clinical efficacy, liver function indices (aspartate aminotransferase, alanine aminotransferase, total bilirubin, and albumin), tumor serum markers, and adverse reactions were compared between the groups.

Results: The objective response and disease control rates were significantly higher in group A (80.23% and 97.67%, respectively) than in group B (60.47% and 87.21%, respectively) ( < 0.05). Post-treatment levels of aspartate aminotransferase, alanine aminotransferase, and total bilirubin were lower in group A than in group B ( < 0.05), whereas post-treatment levels of albumin in group A were comparable to those in group B ( > 0.05). Post-treatment levels of tumor serum markers were significantly lower in group A than in group B ( < 0.05). Patients in groups A and B had mild-to-moderate fever and vomiting symptoms, which improved with conservative treatment. The total incidence of adverse reactions was significantly higher in group B (22.09%) than in group A (6.97%) ( < 0.05).

Conclusion: DEB-TACE has obvious therapeutic effects on patients with PHC. It can improve liver function indices and tumor markers of patients without increasing the rate of liver toxicity or adverse reactions.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622076PMC
http://dx.doi.org/10.4240/wjgs.v16.i11.3463DOI Listing

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