Filipe Veloso Gomes1, João A Oliveira2, Mariana Tomé Correia3, Nuno Vasco Costa3, João Abrantes4, Daniel Torres3, Pedro Pereira5, Ana Isabel Ferreira6, José Hugo Luz3, Erik Spaepen7, Tiago Bilhim8, Élia Coimbra3. 1. Interventional Radiology Unit, Hepato-Biliary-Pancreatic and Transplant Center, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Rua da Beneficência 8, 1050-099, Lisbon, Portugal. Electronic address: fvgomes@gmail.com. 2. Department of Radiology, Hospital Geral de Santo António, Centro Hospitalar do Porto, Porto, Portugal. 3. Interventional Radiology Unit, Hepato-Biliary-Pancreatic and Transplant Center, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Rua da Beneficência 8, 1050-099, Lisbon, Portugal. 4. Department of Radiology, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal. 5. Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal. 6. Department of Radiology, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisbon, Portugal. 7. SBD Analytics, Bekkevoort, Belgium. 8. Interventional Radiology Unit, Hepato-Biliary-Pancreatic and Transplant Center, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Rua da Beneficência 8, 1050-099, Lisbon, Portugal; Department of Radiology, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal.
Abstract
PURPOSE: To evaluate the efficacy and safety of transarterial chemoembolization with polyethylene glycol (PEG) drug-eluting embolic agents in the treatment of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A single-center retrospective study of 302 patients (258 men; 85.4%) with HCC treated during a 20-month period was conducted. The mean patient age was 66 years ± 10; 142 (47%) had Barcelona Clinic Liver Cancer stage A disease and 134 had (44.4%) stage B disease; 174 (57.6%) had a single HCC tumor, 65 (21.5%) had 2, and 62 (20.9%) had 3 or more. Mean index tumor size was 36.6 mm ± 24.8. One-month follow-up computed tomography (CT) response per modified Response Evaluation Criteria In Solid Tumors and clinical and biochemical safety were analyzed. Progression-free and overall survival were calculated by Kaplan-Meier method. RESULTS: Median follow-up time was 11.9 months (95% confidence interval, 11.0-13.0 mo). One-month follow-up CT revealed complete response in 179 patients (63.2%), partial response in 63 (22.3%), stable disease in 16 (5.7%), and progressive disease in 25 (8.8%). The most frequent complications were postembolization syndrome in 18 patients (6%), liver abscess in 5 (1.7%), and puncture-site hematoma in 3 (1%). Biochemical toxicities occurred in 57 patients (11.6%). Survival analysis at 12 months showed a progression-free survival rate of 65.9% and overall survival rate of 93.5%. Patients who received transplants showed a 57.7% rate of complete pathologic response. CONCLUSIONS: Chemoembolization with PEG embolic agents for HCC is safe and effective, achieving an objective response rate of 85.5%.
PURPOSE: To evaluate the efficacy and safety of transarterial chemoembolization with polyethylene glycol (PEG) drug-eluting embolic agents in the treatment of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A single-center retrospective study of 302 patients (258 men; 85.4%) with HCC treated during a 20-month period was conducted. The mean patient age was 66 years ± 10; 142 (47%) had Barcelona Clinic Liver Cancer stage A disease and 134 had (44.4%) stage B disease; 174 (57.6%) had a single HCC tumor, 65 (21.5%) had 2, and 62 (20.9%) had 3 or more. Mean index tumor size was 36.6 mm ± 24.8. One-month follow-up computed tomography (CT) response per modified Response Evaluation Criteria In Solid Tumors and clinical and biochemical safety were analyzed. Progression-free and overall survival were calculated by Kaplan-Meier method. RESULTS: Median follow-up time was 11.9 months (95% confidence interval, 11.0-13.0 mo). One-month follow-up CT revealed complete response in 179 patients (63.2%), partial response in 63 (22.3%), stable disease in 16 (5.7%), and progressive disease in 25 (8.8%). The most frequent complications were postembolization syndrome in 18 patients (6%), liver abscess in 5 (1.7%), and puncture-site hematoma in 3 (1%). Biochemical toxicities occurred in 57 patients (11.6%). Survival analysis at 12 months showed a progression-free survival rate of 65.9% and overall survival rate of 93.5%. Patients who received transplants showed a 57.7% rate of complete pathologic response. CONCLUSIONS: Chemoembolization with PEGembolic agents for HCC is safe and effective, achieving an objective response rate of 85.5%.