Abstract
BackgroundTo evaluate survival data and local tumor control after transarterial chemoembolization in two groups with different embolization protocols for the treatment of HCC patients.MethodsNinty-nine patients (mean age: 63.6 years), 78 male (78.8%) with HCC were repeatedly treated with chemoembolization in 4-week-intervals. Eighty-eight patients had BCLC-Stage-B and in 11 patients, chemoembolization was performed for bridging (BCLC-Stage-A). In total, 667 chemoembolization treatments were performed (mean 6.7 treatments/patient). The administered chemotherapeutic agent included mitomycin. For embolization, lipiodol only (n = 51;51.5%; mean age 63.8 years; 38 male), or lipiodol plus degradable starch microspheres (DSM) (n = 48; 48.5%; mean age 63.4 years; 40 male) were used. The local tumor response was assessed by MRI using Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1). Patient survival times were evaluated using Kaplan-Meier curves and log-rank tests.ResultsThe local tumor control in the lipiodol-group was: PR (partial response) in 11 (21.6%), SD (stable disease) in 32 (62.7%) and PD (progressive disease) in 8 cases (15.7%). In the lipiodol-DSM-group, PR was seen in 14 (29.2%), SD in 22 (45.8%), and PD in 12 (25.0%) individuals (p = 0.211). The median survival of patients after chemoembolization with lipiodol was 25 months and in the lipiodol-DSM-group 28 months (p = 0.845).ConclusionOur data suggest a slight benefit of the use of lipiodol and DSM in comparison of using lipiodol only for chemoembolization of HCC in terms of local tumor control and survival data, this trend did not reach the level of significance.
Highlights
To evaluate survival data and local tumor control after transarterial chemoembolization in two groups with different embolization protocols for the treatment of Hepatocellular carcinoma (HCC) patients
The post-interventional evaluation was based on the Response evaluation criteria in solid tumors (RECIST) 1.1 und all patients were revealed using this criteria: partial response (PR) (Fig. 1) in 25.3% (25/99), stable disease (SD) in 54.5% (54/99), and progressive disease (PD) in 20.2% (20/99) of all patients
In the lipiodol-degradable starch microspheres (DSM) group (48.5%; 48/99), partial response was encountered in 29.2% (14/48), 45.8% (22/48) had stable disease, and progressive disease was observed in 25.0% (12/48) of patients
Summary
To evaluate survival data and local tumor control after transarterial chemoembolization in two groups with different embolization protocols for the treatment of HCC patients. Liver transplantation, and tumor ablation, e.g. using radio frequency or thermic techniques, are the only curative options for patients with HCC [2]. TACE is a treatment option for non-resectable HCC [6, 7], resulting in a high cytotoxic effect after usage of chemotherapeutic drugs and causing ischaemia due to the use of embolization particles [2, 4, 8]. TACE might be a useful treatment option to improve outcomes of potentially curative therapies or as a bridging therapy to liver transplantation [8]
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