Chemoembolization with doxorubicin drug-eluting beads for unresectable hepatocelluar carcinoma with portal vein thrombosis.

Abstract

e14638 Background: Conventional transarterial chemoembolization (TACE) and yttrium-90 radioembolization (Y-90) have long been used as palliative care for patients with unresectable hepatocellular carcinoma (HCC). TACE with doxorubicin drug eluting beads (DEB) is a novel locoregional treatment modality for unresectable HCC. Current study explores survival after doxorubicin DEB compared to conventional TACE and Y-90 for unresectable HCC with portal vein thrombosis (PVT). Methods: Consecutive patients with HCC and PVT who received transcatheter therapy with Doxorubicin DEB, conventional TACE, or Y-90 as sole therapy were studied. Patients who underwent resection, transplantation, or combination therapies have been excluded from the study. Survival was obtained from the date of first transcatheter therapy and from the diagnosis of HCC. 6 month, 1 year and 2 year cumulative mortality was calculated. Statistical analysis was performed using Kaplan Meier Estimator with a log rank test, Chi-square and independent T-tests. Results: A total of 49 patients were included in the study. 40 (81.6%) received therapy with DEB (group A) and 9 (18.4%) underwent conventional TACE or Y-90 (group B). Of group B, 4 (44.4%) received conventional TACE and 5 (55.6%) received Y-90. Age (p = 0.140), sex (p = 1.000), race (p = 0.127) and Child-Pugh Class (p = 0.609) in the two groups were statistically similar. Median survivals from the diagnosis of HCC in groups A and B were 536 days (276-796) and 138 days (9-267) (p = 0.004). The survival rates in group A and B at 6 months, 1 year and 2 years were 80%, 62%, 36% vs. 33%, 22%, 11%. Median survival from the first transcatheter therapy was 535 days after DEB, 31 days after conventional TACE, and 54 days after Y90 (p = 0.006). Conclusions: Preliminary results indicate favorable survivals with transcatheter therapy with Doxorubicin DEB over conventional TACE and Y-90 for unresectable HCC and PVT. No significant financial relationships to disclose.