【原】中国学者对乳腺癌肝转移经动脉化学栓塞进行系统回顾

　　经动脉化学栓塞对乳腺癌肝转移患者生存的影响如何？相关数据有限。

　　2017年9月13日，欧洲乳腺癌专科学会《乳腺》在线发表南方医科大学珠江医院、中山大学肿瘤防治中心的研究报告，通过系统回顾评定了经动脉化学栓塞对乳腺癌肝转移患者的安全性和有效性。

　　该研究对2001年1月1日～2000年1月1日发表的临床研究进行检索，提取所有研究的生存数据和毒副作用数据，以评定经动脉化学栓塞的有效性（包括总生存、无病生存、缓解率）和安全性。

　　结果，检索出符合条件的10项研究共计519例乳腺癌肝转移患者，其中单纯经动脉化学栓塞、经动脉化学栓塞＋全身化疗、单纯全身化疗的患者分别占78.0%、9.9%、12.1%。

　　所有接受经动脉化学栓塞患者的合并中位总生存7.3～47.0个月，中位无病生存2.9～17.0个月，缓解率7.0～73.5%，合并的3～4级副作用（血液毒性、肝脏毒性、栓塞后综合征）发生率0.0～17.4%。

　　因此，经动脉化学栓塞是乳腺癌肝转移的有效治疗方法之一，适用于手术或全身化疗有禁忌证的患者，并应监测毒副作用。特定患者是否适合接受经动脉化学栓塞，取决于多学科小组讨论。

相关阅读

• 乳腺癌肝转移研究进展

• 中国学者发现手术可改善乳腺癌患者孤立肺转移的生存结局

Breast. 2017 Sep 13;36:25-30. [Epub ahead of print]

Transarterial chemoembolisation for breast cancer with liver metastasis: A systematic review.

Mengchuan Wang, Jian Zhang, Shufeng Ji, Guoli Shao, Kankan Zhao, Zixiang Wang, Aiguo Wu.

Zhujiang Hospital, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China; Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.

Highlights

• A systematic review was conducted to evaluate the safety and efficacy of TACE on patients of BCLM.

• TACE is appropriate for patients who are not suitable to surgery or systematic chemotherapy.

• Toxic side effects should be monitored after TACE is performed.

BACKGROUND: There is limited data on the impact of transarterial chemoembolisation (TACE) on survival in patients of breast cancer with liver metastasis (BCLM).

METHODS: A systematic review was conducted to assess TACE effect on BCLM patients. A search for clinical studies published since 1/1/2000 to 1/1/2017 was performed. Survival data from all studies were extracted to evaluate the efficacy of TACE, including overall survival, disease free survival and response rate. Toxic side effects data were also extracted to assess the safety of TACE.

RESULTS: A total of 10 studies with 519 BCLM patients were identified. 78.0% patients were treated with TACE, 9.9% were treated with TACE plus systematic chemotherapy and 12.1% were treated with systematic chemotherapy alone. Pooled median overall survival of patients who received TACE ranged from 7.3 to 47.0 months, median disease free survival ranged from 2.9 to 17.0 months and response rates ranged from 7.0 to 73.5%. Pooled Grade 3 and 4 side effects (blood toxicities, liver toxicity and post-embolization syndrome) ranged from 0.0 to 17.4%.

CONCLUSIONS: TACE is one of an effective treatment for BCLM and whether a specific patient is appropriate to receive TACE depends on a multiple disciplinary team discussion.

KEYWORDS: Breast cancer with liver metastasis, Transarterial chemoembolisation

DOI: 10.1016/j.breast.2017.09.001