Joon Ho Kwon1, Gyoung Min Kim2,3, Kichang Han1, Jong Yun Won1, Man Deuk Kim1, Do Yun Lee1, Junhyung Lee1, Woosun Choi1, Yong Seek Kim1, Do Young Kim4, Kwang-Hyub Han4. 1. Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea. 2. Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea. GYOUNGMIN@yuhs.ac. 3. Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea. GYOUNGMIN@yuhs.ac. 4. Department of Internal Medicine, Institution of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND: Radioembolization induced liver disease (REILD) is a possible sequela of transarterial radioembolization (TARE), particularly in cases of whole-liver treatment. To mitigate this problem, the safety and efficacy of combined transarterial chemoembolization (TACE) and TARE were evaluated for patients with bilobar hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Nineteen patients (mean age 60 years; range 27-82 years) treated for HCC between June 2012 and September 2014 were included in the analysis. Each patient was treated with combined TARE and TACE for bilobar HCC, with or without portal vein thrombosis. The hepatic lobe with large HCC was treated with TARE, and the other lobe with small HCC(s) was treated with TACE. Laboratory and clinical data were investigated to determine REILD occurrence. Survival data were analyzed to compare the treatment efficacy of alternative treatment modalities, including TACE and sequential TARE. RESULTS: All patients underwent TARE for a dominant tumor in one lobe and TACE for small nodule(s) in the other lobe of the liver. The mean yttrium-90 microspheres used in TARE were 2.8 GBq (range; 1.0-3.5 GBq), and the mean doses of doxorubicin and iodized oil were 24.5 mg and 5.2 mL, respectively, for TACE. No statistical differences were noted between laboratory data measured before and after treatment, and no procedure-related major clinical complications occurred. The median time-to-progression of patients was 10.0 months, and the median overall survival was 27.3 months. CONCLUSION: Combined radioembolization and chemoembolization appears to be a safe and effective treatment modality for bilobar HCC.
BACKGROUND: Radioembolization induced liver disease (REILD) is a possible sequela of transarterial radioembolization (TARE), particularly in cases of whole-liver treatment. To mitigate this problem, the safety and efficacy of combined transarterial chemoembolization (TACE) and TARE were evaluated for patients with bilobar hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Nineteen patients (mean age 60 years; range 27-82 years) treated for HCC between June 2012 and September 2014 were included in the analysis. Each patient was treated with combined TARE and TACE for bilobar HCC, with or without portal vein thrombosis. The hepatic lobe with large HCC was treated with TARE, and the other lobe with small HCC(s) was treated with TACE. Laboratory and clinical data were investigated to determine REILD occurrence. Survival data were analyzed to compare the treatment efficacy of alternative treatment modalities, including TACE and sequential TARE. RESULTS: All patients underwent TARE for a dominant tumor in one lobe and TACE for small nodule(s) in the other lobe of the liver. The mean yttrium-90 microspheres used in TARE were 2.8 GBq (range; 1.0-3.5 GBq), and the mean doses of doxorubicin and iodized oil were 24.5 mg and 5.2 mL, respectively, for TACE. No statistical differences were noted between laboratory data measured before and after treatment, and no procedure-related major clinical complications occurred. The median time-to-progression of patients was 10.0 months, and the median overall survival was 27.3 months. CONCLUSION: Combined radioembolization and chemoembolization appears to be a safe and effective treatment modality for bilobar HCC.
Entities:
Keywords:
Barcelona clinic liver cancer (BCLC); Hepatocellular carcinoma; Radioembolization induced liver disease; Transarterial chemoembolization; Transarterial radioembolization