Dirk Schnapauff1, Bruno R Tegel2, Maciej J Powerski3, Federico Colletini2, Bernd Hamm2, Bernhard Gebauer2. 1. Department of Radiology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany dirk.schnapauff@charite.de. 2. Department of Radiology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany. 3. Department of Radiology and Nuclear Medicine, Otto-von-Guericke University, Magdeburg, Germany.
Abstract
BACKGROUND/AIM: Treatment of patients with large hepatocellular carcinoma (HCC) remains challenging and survival in advanced tumor stages is limited. This study was conducted to investigate the efficacy of embolization followed by computed tomography (CT)-guided interstitial high-dose-rate brachytherapy (CT-HDRBT) in patients with unresectable HCC. PATIENTS AND METHODS: A total of 47 patients undergoing CT-HDRBT were divided into 2 groups: i) patients previously treated with transarterial chemoembolization (TACE) and ii) patients treated with bland transarterial embolization (TAE). The primary endpoint was overall survival (OS), while secondary endpoints were the time to progression (TTP) and the local progression rate. RESULTS: A total of 78 lesions were treated. The mean size of the main tumors was 58.3 mm. The median OS in TACE and TAE groups was 28.9 months and 32.3 months, respectively (p=NS). The median OS of patients classified as BCLC stage A using the Barcelona Clinic Liver Cancer classification system (BCLC) was 32.3 months, while the median OS of patients in BCLC stage B and C was 36.9 and 17.7 months, respectively. The local progression rate was 7.7% (6/78), with no statistically significant difference between TACE and TAE. The median TTP was significantly longer in the TACE group compared to the TAE group (11.7 months and 10.3 months, respectively). CONCLUSION: Treatment with transarterial embolization and subsequent CT-HDRBT leads to a very promising survival rate for patients with unresectable HCC. Copyright
BACKGROUND/AIM: Treatment of patients with large hepatocellular carcinoma (HCC) remains challenging and survival in advanced tumor stages is limited. This study was conducted to investigate the efficacy of embolization followed by computed tomography (CT)-guided interstitial high-dose-rate brachytherapy (CT-HDRBT) in patients with unresectable HCC. PATIENTS AND METHODS: A total of 47 patients undergoing CT-HDRBT were divided into 2 groups: i) patients previously treated with transarterial chemoembolization (TACE) and ii) patients treated with bland transarterial embolization (TAE). The primary endpoint was overall survival (OS), while secondary endpoints were the time to progression (TTP) and the local progression rate. RESULTS: A total of 78 lesions were treated. The mean size of the main tumors was 58.3 mm. The median OS in TACE and TAE groups was 28.9 months and 32.3 months, respectively (p=NS). The median OS of patients classified as BCLC stage A using the Barcelona Clinic Liver Cancer classification system (BCLC) was 32.3 months, while the median OS of patients in BCLC stage B and C was 36.9 and 17.7 months, respectively. The local progression rate was 7.7% (6/78), with no statistically significant difference between TACE and TAE. The median TTP was significantly longer in the TACE group compared to the TAE group (11.7 months and 10.3 months, respectively). CONCLUSION: Treatment with transarterial embolization and subsequent CT-HDRBT leads to a very promising survival rate for patients with unresectable HCC. Copyright
Authors: Florian Nima Fleckenstein; Maximilian Julius Roesel; Maja Krajewska; Timo Alexander Auer; Federico Collettini; Tazio Maleitzke; Georg Böning; Giovanni Federico Torsello; Uli Fehrenbach; Bernhard Gebauer Journal: Cancers (Basel) Date: 2021-12-24 Impact factor: 6.639
Authors: Han Xu; Robin Schmidt; Charlie Alexander Hamm; Isabel Theresa Schobert; Yubei He; Georg Böning; Martin Jonczyk; Bernd Hamm; Bernhard Gebauer; Lynn Jeanette Savic Journal: Ther Adv Med Oncol Date: 2021-09-08 Impact factor: 8.168