Even with liver-targeted therapies, uveal melanoma with hepatic metastasis remains a challenge. The aim of this study was to compare the outcome of patients treated with either SIRT or CS-PHP. We included 62 patients with hepatic metastasized uveal melanoma (n = 34 with SIRT, receiving 41 cycles; n = 28 with CS-PHP, receiving 56 cycles) that received their treatments between 12/2013 and 02/2020 at a single center. We evaluated their response according to the RECIST 1.1, as well as progression-free survival (PFS) and overall survival (OS), after the initiation of the first cycle of the liver-directed treatment using Cox regression, adjusted via propensity score analysis for confounders, including the amount of hepatic involvement. The disease control rate was 18% for SIRT and 30% for CS-PHP. The median (range) of PFS was 127.5 (19–1912) days for SIRT and 408.5 (3–1809) days for CS-PHP; adjusted Cox regression showed no significant difference (p= 0.090). The median (range) of OS was 300.5 (19–1912) days for SIRT and 516 (5–1836) days for CS-PHP; adjusted Cox regression showed a significant difference (p= 0.006). In our patient cohort, patients treated with CS-PHP showed a significantly longer OS than patients treated with SIRT. CS-PHP might therefore be preferable for patients with liver-dominant metastatic uveal melanoma.
即使采用肝脏靶向治疗，肝转移性葡萄膜黑色素瘤的治疗仍面临挑战。本研究旨在比较选择性内放射治疗与经皮肝动脉灌注化疗联合血液过滤两种疗法的疗效。我们纳入了2013年12月至2020年2月期间在同一中心接受治疗的62例肝转移性葡萄膜黑色素瘤患者（其中34例接受选择性内放射治疗，共41个周期；28例接受经皮肝动脉灌注化疗联合血液过滤，共56个周期）。根据RECIST 1.1标准评估治疗反应，并采用经倾向评分校正的Cox回归模型（校正因素包括肝脏受累程度）分析首次肝脏定向治疗后的无进展生存期和总生存期。选择性内放射治疗组的疾病控制率为18%，经皮肝动脉灌注化疗联合血液过滤组为30%。选择性内放射治疗组的中位无进展生存期为127.5天（范围19-1912天），经皮肝动脉灌注化疗联合血液过滤组为408.5天（范围3-1809天）；校正后的Cox回归分析显示两组无显著差异（p=0.090）。选择性内放射治疗组的中位总生存期为300.5天（范围19-1912天），经皮肝动脉灌注化疗联合血液过滤组为516天（范围5-1836天）；校正后的Cox回归分析显示两组存在显著差异（p=0.006）。在本研究队列中，接受经皮肝动脉灌注化疗联合血液过滤治疗的患者总生存期显著长于接受选择性内放射治疗的患者。因此对于肝脏优势型转移性葡萄膜黑色素瘤患者，经皮肝动脉灌注化疗联合血液过滤可能是更优选择。
肿瘤(癌症)患者之家