Tommaso Cascella1, Enrico Matteo Garanzini2, Rodolfo Lanocita1, Carlo Morosi1, Federica Riva3, Giorgio Greco1, Carlo Sposito4,5, Vincenzo Mazzaferro4,5, Alfonso Marchianò1, Carlo Spreafico1. 1. Interventional Vascular and Hepatobiliary Unit, Department of Radiodiagnostics and Radiotherapy, IRCCS Fondazione Istituto Nazionale Tumori di Milano, Milan, Italy. 2. Interventional Vascular and Hepatobiliary Unit, Department of Radiodiagnostics and Radiotherapy, IRCCS Fondazione Istituto Nazionale Tumori di Milano, Milan, Italy. enrico.garanzini@istitutotumori.mi.it. 3. Postgraduation School of Radiology, University of Milan, Milan, Italy. 4. General Surgery and Liver Transplantation Unit, IRCCS Fondazione Istituto Nazionale Tumori di Milano, Milan, Italy. 5. Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
Abstract
PURPOSE: Different types of drug-eluting beads have been proposed for hepatocellular carcinoma (HCC) treatment, but long-term results are not well known. We report safety, efficacy and long-term overall survival of HCC patients not amenable of curative therapies treated with transcatheter arterial chemoembolization (TACE) using drug-eluting beads sized 70-150 micron. MATERIALS AND METHODS: This single-center retrospective study included 125 patients with Barcelona Clinic Liver Cancer stage A (80), B (45) and compensated cirrhosis. TACE was executed injecting drug-elutings microparticles loaded with 75 mg of Doxorubicine and was repeated in patients with partial response or stable disease after one month. Adverse events, response according to modified Response Evaluation Criteria in Solid Tumors and overall survival were assessed. RESULTS: Chemoembolization with 70-150 micron beads revealed an objective response rate of 88% according to mRECIST criteria and complete response was 60%. After a median follow-up of 53.3 months, overall survival was 36.6 months. Data were censored at the date of liver transplantation in 35 patients. 33 on 125 patients (26,4%) experienced at least one adverse event. We recorded a total of 102 adverse events and 18 were of a high grade (G3-G4). 30 day mortality was 0%. CONCLUSION: Chemoembolization with very small particles (70-150 µm) is an effective and safe treatment in unresectable HCC both as a primary therapy or as bridge to transplantation.
PURPOSE: Different types of drug-eluting beads have been proposed for hepatocellular carcinoma (HCC) treatment, but long-term results are not well known. We report safety, efficacy and long-term overall survival of HCC patients not amenable of curative therapies treated with transcatheter arterial chemoembolization (TACE) using drug-eluting beads sized 70-150 micron. MATERIALS AND METHODS: This single-center retrospective study included 125 patients with Barcelona Clinic Liver Cancer stage A (80), B (45) and compensated cirrhosis. TACE was executed injecting drug-elutings microparticles loaded with 75 mg of Doxorubicine and was repeated in patients with partial response or stable disease after one month. Adverse events, response according to modified Response Evaluation Criteria in Solid Tumors and overall survival were assessed. RESULTS: Chemoembolization with 70-150 micron beads revealed an objective response rate of 88% according to mRECIST criteria and complete response was 60%. After a median follow-up of 53.3 months, overall survival was 36.6 months. Data were censored at the date of liver transplantation in 35 patients. 33 on 125 patients (26,4%) experienced at least one adverse event. We recorded a total of 102 adverse events and 18 were of a high grade (G3-G4). 30 day mortality was 0%. CONCLUSION: Chemoembolization with very small particles (70-150 µm) is an effective and safe treatment in unresectable HCC both as a primary therapy or as bridge to transplantation.
Authors: Jordi Bruix; Jean-Luc Raoul; Morris Sherman; Vincenzo Mazzaferro; Luigi Bolondi; Antonio Craxi; Peter R Galle; Armando Santoro; Michel Beaugrand; Angelo Sangiovanni; Camillo Porta; Guido Gerken; Jorge A Marrero; Andrea Nadel; Michael Shan; Marius Moscovici; Dimitris Voliotis; Josep M Llovet Journal: J Hepatol Date: 2012-06-19 Impact factor: 25.083
Authors: Diane K Reyes; Josephina A Vossen; Ihab R Kamel; Nilofer S Azad; Tamara A Wahlin; Michael S Torbenson; Michael A Choti; Jean-Francois H Geschwind Journal: Cancer J Date: 2009 Nov-Dec Impact factor: 3.360