Jun Zhou1, Ying Liu2, Zhizhong Ren3, Yuewei Zhang3, Ming Zhang4. 1. Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shanxi; Department of Interventional Radiology, Affiliated Zhongshan Hospital of Dalian university, Dalian, Liaoning, China. 2. Department of Interventional Radiology, Affiliated Zhongshan Hospital of Dalian university, Dalian, Liaoning, China. 3. Interventional Radiology Therapy Center, Beijing Tsinghua Changgung Hospital, Beijing, China. 4. Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shanxi, China.
Abstract
OBJECTIVE: The purpose of this investigation is to present a preliminary clinical experience in transarterial chemoembolization (TACE) with gelatin sponge microparticles (GSMs) for barcelona clinic liver cancer (BCLC) Stage C and large hepatocellular carcinoma (HCC) patients in China. MATERIALS AND METHODS: Between August 2009 and August 2012, 20 BCLC Stage C HCC patients with tumor size ≥5 cm undergoing GSMs-TACE were retrospectively analyzed. Tumor response was evaluated using modified response evaluation criteria in solid tumors (mRECIST) with enhanced magnetic resonance/computed tomography imaging performed 4-6 weeks after each GSMs-TACE procedure. Kaplan-Meier curves were used to assess overall survival (OS). Complications postprocedure was also analyzed. RESULTS: In this cohort of 20 HCC patients, vascular invasion was present in 8 patients (40%), extrahepatic metastases in 6 patients (30%), and both in 6 individuals (30%). Median tumor size was 9.9 ± 3.2 cm. All procedures were successfully performed with minimal complications. The mean number of TACE per patient was 2.6 sessions (range 1-5). Median OS (mOS) was 14 months for the entire study population. Survival rates at 6 and 12 months were 85% and 73.7%, respectively. According to mRECIST criteria, follow-up images were obtained 6 months after initial GSMs-TACE. Five patients (25.0%) achieved complete response, 8 patients (40.0%) had partial response, 4 (20.0%) had stable disease, and 3 (15.0%) had progressive disease. The objective response rate for TACE was 65%. CONCLUSIONS: From our preliminary clinical experience, GSMs-TACE in the treatment of BCLC Stage C and large HCC appears to offer favorable survival and tumor response with low morbidity. However, further prospective studies are required to assess its safety and efficacy.
OBJECTIVE: The purpose of this investigation is to present a preliminary clinical experience in transarterial chemoembolization (TACE) with gelatin sponge microparticles (GSMs) for barcelona clinic liver cancer (BCLC) Stage C and large hepatocellular carcinoma (HCC) patients in China. MATERIALS AND METHODS: Between August 2009 and August 2012, 20 BCLC Stage C HCC patients with tumor size ≥5 cm undergoing GSMs-TACE were retrospectively analyzed. Tumor response was evaluated using modified response evaluation criteria in solid tumors (mRECIST) with enhanced magnetic resonance/computed tomography imaging performed 4-6 weeks after each GSMs-TACE procedure. Kaplan-Meier curves were used to assess overall survival (OS). Complications postprocedure was also analyzed. RESULTS: In this cohort of 20 HCC patients, vascular invasion was present in 8 patients (40%), extrahepatic metastases in 6 patients (30%), and both in 6 individuals (30%). Median tumor size was 9.9 ± 3.2 cm. All procedures were successfully performed with minimal complications. The mean number of TACE per patient was 2.6 sessions (range 1-5). Median OS (mOS) was 14 months for the entire study population. Survival rates at 6 and 12 months were 85% and 73.7%, respectively. According to mRECIST criteria, follow-up images were obtained 6 months after initial GSMs-TACE. Five patients (25.0%) achieved complete response, 8 patients (40.0%) had partial response, 4 (20.0%) had stable disease, and 3 (15.0%) had progressive disease. The objective response rate for TACE was 65%. CONCLUSIONS: From our preliminary clinical experience, GSMs-TACE in the treatment of BCLC Stage C and large HCC appears to offer favorable survival and tumor response with low morbidity. However, further prospective studies are required to assess its safety and efficacy.