Abstract
Transarterial chemoembolization (TACE) with drug-eluting beads (DEB) is a new palliative treatment method for patients with hepatocellular carcinoma (HCC). Little is known about the efficiency of DEB-TACE for patients with HCC. The purpose of our study was to evaluate the treatment efficacy (survival rate, tumor response) and safety of DEB-TACE for inoperable HCC and to identify the predictors of survival in patients with unresectable HCC. Twenty-six patients (18 Child-Pugh A, 8 Child-Pugh B) underwent chemoembolization with doxorubicin DEB, including 5 women and 21 men with a mean age of 67.04 years (range 40–86 years). Twenty patients had one DEB-TACE procedure, while the remaining six had two procedures. Overall median survival and survival at 6 and 12 months were calculated. Meanwhile, the response rate was assessed using response evaluation criteria in solid tumors criteria on computed tomography/magnetic resonance imaging at 1 and 6 months. Overall survival rates at 6 months and 1 year from the first administration of doxorubicin DEB-TACE were 80% and 57%, respectively. At 1 and 6 months, objective tumor response rates were 46.2% and 57.1%, respectively. Child-Pugh class, Okuda staging, Cancer of the Liver Italian Programme score, Barcelona Clinic Liver Cancer staging, serum albumin level, Eastern Cooperative Oncology Group performance status, and tumor morphology and volume were found to be prognostic factors for survival. All of the procedures were technically successful, and there were no major complications. Eighteen patients died during the study period and eight survived.Transarterial chemoembolization with DEB is safe and well tolerated in patients with inoperable HCC. Additional prospective randomized controlled studies are required to assess the efficiency of DEB-TACE.
Highlights
Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy and the third leading cause of cancer-related deaths
Thirty-one drug-eluting beads (DEB)-Transarterial chemoembolization (TACE) procedures were performed in 26 patients (5 women and 21 men with a mean age of 67.04 years) with inoperative HCC at our angiographic institution from January 2007 to May 2011
The procedures were technically successful in all patients
Summary
Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy and the third leading cause of cancer-related deaths. The incidence of HCC is increasing and it causes more than 600,000 deaths globally per year [1]. Most HCC patients have underlying cirrhosis due to chronic viral hepatitis [2]. Screening and surveillance programs may raise early detection and diagnosis of HCC when liver function is preserved and there are no cancerrelated symptoms. Liver transplantation, and ablation are the only curative treatments for HCC, but at first presentation, only 30% of patients are candidates for curative treatments [4]. Transarterial chemoembolization (TACE) has become the standard of care for patients with HCC not amenable to surgical or ablative treatment if extrahepatic metastases and advanced liver disease are lacking [5]
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