Ya Ruth Huo1, Hao Xiang2, Michael Vinchill Chan2,3, Christine Chan2,4. 1. Bankstown-Campbelltown Hospital, South Western Sydney Clinical School, UNSW Medicine and the University, Sydney, New South Wales, Australia. 2. Department of Radiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia. 3. Concord Hospital Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia. 4. Department of Radiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Abstract
INTRODUCTION: This study investigates the outcomes and safety of 70-150 μm and 100-300 μm doxorubicin drug-eluting bead transarterial chemoembolisation (DEB-TACE) in patients with unresectable hepatocellular carcinoma (HCC). METHODS: Retrospective, cohort study of 51 patients treated with DEB-TACE for unresectable HCC was studied: 23 with 100-300 μm particles and 28 with 70-150 μm particles. Overall, survival (OS), progression-free survival (PFS), tumour response and prognostic factors were assessed. RESULTS: The median OS of the entire cohort was 30 months. The median OS and median PFS for 70-150 μm particles were not reached, whilst for the 100-300 μm group, it was 29.2 months and 15.0 months, respectively. The 6-month, 1-year and 2-year OS for 70-150 μm was 96%, 86% and 85% versus the 100-300 μm particles size of 83%, 64% and 44%, respectively. At 1-month follow-up, patients treated with 70-150 μm had significantly better mRECIST tumour response compared to 100-300 μm (complete response 38.5% vs. 19%; partial response 57.7% vs. 42.9%; stable disease 0% vs. 4.8%; progressive disease 3.8% vs. 33.3%, P = 0.027). Patients treated with 100-300 μm DEBs were significantly more likely to have progressive disease on 1-month follow-up imaging compared those treated with 70-150 μm DEB sizes (odds ratio 7.15, P = 0.007). The 30-day mortality rate was similar between the two groups (3.6% for 70-150 μm vs. 4.3% for 100-300 μm). Multivariate analysis demonstrated entire cohort OS was significantly associated with BCLC stage (aHR: 10.5, P = 0.002), albumin (aHR: 15.0, P = 0.02) and ALP (aHR 62, P = 0.001). CONCLUSIONS: DEB-TACE with 70-150 μm particles demonstrates improved 1-month objective tumour response compared to 100-300 μm, whilst having a similar safety profile. Elevated ALP, lower albumin and higher BCLC stage were significantly associated with poorer survival outcomes.
INTRODUCTION: This study investigates the outcomes and safety of 70-150 μm and 100-300 μm doxorubicin drug-eluting bead transarterial chemoembolisation (DEB-TACE) in patients with unresectable hepatocellular carcinoma (HCC). METHODS: Retrospective, cohort study of 51 patients treated with DEB-TACE for unresectable HCC was studied: 23 with 100-300 μm particles and 28 with 70-150 μm particles. Overall, survival (OS), progression-free survival (PFS), tumour response and prognostic factors were assessed. RESULTS: The median OS of the entire cohort was 30 months. The median OS and median PFS for 70-150 μm particles were not reached, whilst for the 100-300 μm group, it was 29.2 months and 15.0 months, respectively. The 6-month, 1-year and 2-year OS for 70-150 μm was 96%, 86% and 85% versus the 100-300 μm particles size of 83%, 64% and 44%, respectively. At 1-month follow-up, patients treated with 70-150 μm had significantly better mRECIST tumour response compared to 100-300 μm (complete response 38.5% vs. 19%; partial response 57.7% vs. 42.9%; stable disease 0% vs. 4.8%; progressive disease 3.8% vs. 33.3%, P = 0.027). Patients treated with 100-300 μm DEBs were significantly more likely to have progressive disease on 1-month follow-up imaging compared those treated with 70-150 μm DEB sizes (odds ratio 7.15, P = 0.007). The 30-day mortality rate was similar between the two groups (3.6% for 70-150 μm vs. 4.3% for 100-300 μm). Multivariate analysis demonstrated entire cohort OS was significantly associated with BCLC stage (aHR: 10.5, P = 0.002), albumin (aHR: 15.0, P = 0.02) and ALP (aHR 62, P = 0.001). CONCLUSIONS:DEB-TACE with 70-150 μm particles demonstrates improved 1-month objective tumour response compared to 100-300 μm, whilst having a similar safety profile. Elevated ALP, lower albumin and higher BCLC stage were significantly associated with poorer survival outcomes.