Transcatheter arterial embolization (TAE) combined with recombinant adeno-viral human p53 genein treatment of patients with unresectable hepatocellular carcinoma (HCC).

Abstract

e14521 Background: To evaluate the response rate and safety of TAE combined with rAd-p53 in treatment of unresectable HCC. Methods: Patients with unresectable HCC affecting one lobe, and with Child-Pugh score A or B, was treated by TAE combined with rAd-p53. The tumor artery was embolized using Gelatin sponage particles(GSPs) with a diameter of 350-560 µm, which degrade in 14 days. The 1-4×1012 rAd-p53 viral particles (VP) diluted in 10 ml of saline solution was mixed with GSPs. The study endpoints were liver function, adverse effects, and response rate. Results: Fifteen patients received 1-2 times of TAE plus rAd-p53 in two months. After 3-5 days of treatment, CT scan showed deceased tumor density in all these cases and gas formation inside of tumor in 6 cases. Three months after the first time of treatment, CT scan showed three cases achieved a complete response (CR), nine partial response (PR) and three stable disease(SD). The response rate was 80%. The average reduction in tumer diameter was 72.5%. Liver function restored to normal level in 7-10 days after treatment. Fever was observed in all case. No severe complications, such as cholantitis or liver abscess were observed. Conclusions: GSPs embolization combined with rAdp53 was safe and effective in the treatment of unresectable HCC. Response rate is much higher than GSPs embolization alone, which was 48% based on historical data.