肝細胞癌のバルーン閉塞下肝動脈化学塞栓療法（Ｂ‐ＴＡＣＥ）の安全性評価：８２症例における有害事象の検討:82症例における有害事象の検討
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We analyzed adverse events associated with balloon-occluded transarterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) in 107 treatments of 82 cases (group A). We also analyzed those associated with TACE using a conventional microcatheter in 310 treatments of 161 cases as a historical control (group B), and compared with group A. The adverse events in group A were death due to duodenal bleeding (n=1), biloma (n=1), skin necrosis (n=1), segmental atrophy (n=1), diaphragmatic paralysis (n=5), severe pain controlled with intravenous morphine (n=5), elevation of ALT level (grade 3: n=17, grade 4: n=5, classified by CTCAE version 4), and elevation of bilirubin level (grade 3: n=3, classified by CTCAE version 4). Those in group B were death due to liver failure and acute tumor lysis syndrome (n=2), biloma (n=4), diaphragmatic paralysis (n=6), severe pain controlled with intravenous morphine (n=7), elevation of ALT level (grade 3: n=12), and elevation of bilirubin level (grade 3: n=1). Elevation of ALT level was dominant in group A with a statistically significant difference (p=0.01, Kruskal-Wallis test). There were no significant differences in the incidence of other adverse events between the groups (p>0.2, Fisher's test, t-test, chi-square test, Kruskal-Wallis test). Dominant elevation of ALT level indicates that B-TACE caused more liver cell damage compared with conventional TACE. However, as far as the incidence of clinically manifested adverse events, B-TACE is as safe as conventional TACE.
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