Abstract
BackgroundNo chemotherapeutic agents have been standardised for transarterial chemoembolisation (TACE). In particular, doxorubicin has no defined optimal dosage in TACE procedures. We compared low versus currently used dose of doxorubicin for TACE in patients with hepatocellular carcinoma (HCC) in terms of severity of post-embolisation syndrome (PES) and overall survival (OS).MethodsFrom October 2014 to March 2018, we enrolled patients with primary HCC scheduled for TACE. Patients were randomised to receive 50 mg (group A) or 100 mg (group B) of doxorubicin. Outcomes were the rate of patients with PES; free-time-to-PES; changes in laboratory results; tumour response at 1, 3, and 6 months after TACE; and overall survival.ResultsTwenty-eight patients (24 males, 4 females) were enrolled, aged 58.9 ± 6.8 years (mean ± standard deviation). Fifteen of them palliated with 50 mg (group A) and 13 with 100 mg (group B) of doxorubicin for a total of 68 TACE procedures (of 28 patients who had repeated TACE procedures). Visual analogue scale (VAS) and duration of pain were significantly differently lower in group A than in group B (p < 0.001). The median duration of fever was shorter in group A than in group B (p = 0.003). No significant differences between both groups were observed for tumour response to TACE and OS. The doxorubicin dose was significantly correlated with duration of pain, fever, and VAS score.ConclusionA lower dose of doxorubicin (50 mg) was associated with fewer PES symptoms compared with 100 mg, without effects on tumour response nor OS.
Highlights
No chemotherapeutic agents have been standardised for transarterial chemoembolisation (TACE)
Twenty-nine patients were randomised into two groups: (i) group A where only 50 mg of doxorubicin was injected with the prepared emulsion and (ii) group B where the injected emulsion contained 100 mg of doxorubicin
Characteristics of the study population Sixty-eight TACE procedures were performed in 28 hepatocellular carcinoma (HCC) patients, the mean age of group A was 60.8 ± 6.4 years and of group B was 56.6 ± 6.8 years, at the time of the first procedure with no statistically significant differences between both groups
Summary
No chemotherapeutic agents have been standardised for transarterial chemoembolisation (TACE). We compared low versus currently used dose of doxorubicin for TACE in patients with hepatocellular carcinoma (HCC) in terms of severity of postembolisation syndrome (PES) and overall survival (OS). Several interventional alternatives such as the local thermal ablation including radiofrequency and microwave ablation, and transarterial embolotherapy such as transarterial hepatic chemoembolisation (TACE) have been introduced for unresectable HCC [4, 5]. Cellular destruction in cases of TACE and systemic release of anti-cancer drug are usually complicated by post-embolisation syndrome (PES) that is manifested by constitutional symptoms followed by patients’ discomfort. The most common complication of TACE is PES consisting of nausea, vomiting, pain in the right upper quadrant, and fever in most patients. PES is responsible for increasing both the patients’ TACE-related length of stay and recurrent readmissions [10,11,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
