Drug-eluting bead trans-arterial chemoembolization combined with microwave ablation therapy vs. microwave ablation alone for early stage hepatocellular carcinoma: a preliminary investigation of clinical value

Juanfang Liu,Jing Li,Huibin Lu,Xinwei Han,Xueliang Zhou,Wenguang Zhang,Hongbin Li

doi:10.1007/s00432-021-03760-x

Abstract

PurposeTo assess the clinical value of drug-eluting bead trans-arterial chemoembolization (DEB-TACE) combined with microwave ablation (MWA) vs. MWA treatment alone for early stage hepatocellular carcinoma (HCC).Materials and methodsConsecutive data from 102 HCC patients at early stage who were referred to our hospital from December 2014 to May 2016 were retrospectively collected. Forty-seven patients underwent DEB-TACE combined with MWA treatment, whereas 55 patients underwent MWA alone. After 1 month of treatment, the tumour responses of the patients were assessed using the mRECIST criteria. Treatment-related complications and hepatic function were also analysed for the two groups. In addition, overall survival (OS) and progression-free survival (PFS) were calculated and compared.ResultsPatients in the combined treatment group (DEB-TACE combined with MWA) presented a better objective response rate (ORR) and disease control rate (DCR) compared with those in the monotherapy group (MWA treatment). The median OS and PFS were longer in the combined treatment group compared with the monotherapy group. Multivariate Cox’s regression further illustrated that DEB-TACE + MWA vs. MWA was an independent protective factor for PFS and OS. No serious treatment-related complications were observed in any of the patients.ConclusionCombined treatment with DEB-TACE appeared to have advantages in prolonging OS and PFS compared to MWA. Therefore, combined treatment was efficient and should be strongly recommended to early stage HCC patients.

Highlights

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related mortality worldwide (Bray et al 2018)
Categorical variables were expressed as numbers or percentages (%), and continuous variables were expressed as the mean ± standard deviation (SD) or median (25th–75th percentiles) as appropriate
Many studies have revealed that patients with hepatocellular carcinoma (HCC) treated with DEB-Transarterial chemoembolization (TACE) tend to present a better response and tolerance than those who undergo TACE treatment

Summary

Introduction

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related mortality worldwide (Bray et al 2018). Arsenic trioxide (ATO) has been suggested to be an effective chemotherapeutic agent used primarily for solid tumours, such as HCC, colorectal, lung, bladder, breast, and pancreatic cancer (Huang et al 2019; Kong et al 2020; Kritharis et al 2013; Wang et al 2018). Transarterial chemoembolization (TACE) or DEB-TACE loading with ATO has been widely used and is effective in the treatment of human primary HCC. Given the advantage of avoiding systemic toxicity, drug-eluting bead trans-arterial chemoembolization (DEB-TACE) has been developed and widely used in combination therapy for HCC. Combination therapy of TACE combined with thermal ablation yielded better treatment efficacy than monotherapy of MWA or TACE treatment in HCC patients, whereas DEBTACE combined with MWA for early stage HCC patients has not yet been investigated. We hypothesized that DEB-TACE and MWA combination therapy might offer promising outcomes for early stage HCC patients

Materials and methods

Results

Discussion