Tumor-feeding artery diameter reduction is associated with improved short-term effect of hepatic arterial infusion chemotherapy plus lenvatinib treatment.

Autor:	Wu DD; Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China., He XF; Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China., Tian C; Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China., Peng P; Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China., Chen CL; Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China., Liu XH; Department of Statistics, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China., Pang HJ; Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China. nfyyphj@163.com.
Jazyk:	angličtina
Zdroj:	World journal of gastroenterology [World J Gastroenterol] 2022 Jul 14; Vol. 28 (26), pp. 3232-3242.
DOI:	10.3748/wjg.v28.i26.3232
Abstrakt:	Background: Recently, hepatic arterial infusion chemotherapy (HAIC) plus lenvatinib has been frequently used to treat unresectable hepatocellular carcinoma (uHCC) in China. In the clinic, the hepatic arteries of some patients shrink significantly during this treatment, leading to improved short-term efficacy. Aim: To investigate the relationship between the shrinkage of hepatic arteries and the short-term effect of HAIC plus lenvatinib treatment. Methods: Sixty-seven participants with uHCC were enrolled in this retrospective study. The patients received HAIC every 3 wk, followed by oral lenvatinib after the first HAIC course. Hepatic artery diameters were measured on CT before treatment and after 1 and 2 mo of treatment. Meanwhile, the changes in tumor capillaries were also examined on pathological specimens before and after 1 mo of treatment. The antitumor response after 1, 3, and 6 mo of treatment was assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). The relationship between the changes in vessel diameters and the short-term effect of the combination treatment was evaluated by receiver-operating characteristic and logistic regression analyses. Results: The hepatic artery diameters were all significantly decreased after 1 and 2 mo of treatment ( P < 0.001), but there was no difference in the vessel diameters between 1 and 2 mo ( P > 0.05). The microvessel density in the tumor lesions decreased significantly after 1 mo of combination treatment ( P < 0.001). According to mRECIST, 46, 41, and 24 patients had complete or partial responses after 1, 3, and 6 mo of treatment, respectively, whereas 21, 21, and 32 patients had a stable or progressive disease at these times, respectively. Shrinkage of the tumor-feeding artery was significantly associated with the tumor response after 1, 3, and 6 mo of treatment ( P < 0.001, P = 0.004, and P = 0.023, respectively); however, changes in other hepatic arteries were not significantly associated with the tumor response. Furthermore, shrinkage of the tumor-feeding artery was an independent factor for treatment efficacy ( P = 0.001, P = 0.001, and P = 0.002 and 1, 3, and 6 mo, respectively). Conclusion: The hepatic arteries shrank rapidly after treatment with HAIC plus lenvatinib, and shrinkage of the tumor-feeding artery diameter was closely related to improved short-term efficacy. Competing Interests: Conflict-of-interest statement: There was no conflict of interest to disclose. (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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