Tumour stiffness associated with tumour response to conventional transarterial chemoembolisation for hepatocellular carcinoma: preliminary findings

Abstract Purpose The aim of this retrospective multicentric study was to compare the tumour response rates of Balloon-occluded Transarterial Chemoembolisation (B-TACE) to non-B-TACE using propensity score matching (PSM) in patients with hepatocellular carcinoma and to investigate the clinical benefit, such as lower rates of TACE re-intervention achieved using B-TACE. Material and Methods The B-TACE procedures (n = 96 patients) were compared with a control group of non-B-TACE treatments (n = 434 pts), performed with conventional (cTACE) or drug-eluting microspheres TACE (DEM-TACE). Data were collected from six European centres from 2015 to 2019. Objective responses (OR) and complete response (CR) rates after the first session and the number of TACE re-interventions were evaluated using PSM (91 patients per arm). Results The best target OR after PSM were similar for both B-TACE and non-B-TACE (90.1% and 86.8%, p = 0.644); however, CR at 1–6 months was significantly higher for B-TACE (59.3% vs. 41.8%, p = 0.026). Patients treated with B-TACE had a significantly lower retreatment rate during the first 6 months (9.9%% vs. 22.0%, p = 0.041). Post-embolisation syndrome (PES) rates were 8.8% in non-B-TACE and 41.8% in B-TACE (p < 0.001), with no significant differences between groups regarding major adverse events. Conclusion B-TACE is safe and effective, achieving higher CR rates than non-B-TACE. Patients undergoing B-TACE had a significantly lower retreatment rate within the first 6 months but higher PES rates. Level of Evidence III Level 3, retrospective study.

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Survival, tumour response and safety of 70‐150 μm versus 100‐300 μm doxorubicin drug‐eluting beads in transarterial chemoembolisation for hepatocellular carcinoma

Journal of Medical Imaging and Radiation Oncology ◽

10.1111/1754-9485.12971 ◽

2019 ◽

Vol 63 (6) ◽

pp. 802-811 ◽

Cited By ~ 4

Author(s):

Ya Ruth Huo ◽

Hao Xiang ◽

Michael Vinchill Chan ◽

Christine Chan

Keyword(s):

Hepatocellular Carcinoma ◽

Tumour Response ◽

Transarterial Chemoembolisation ◽

Drug Eluting Beads ◽

Drug Eluting

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Transarterial chemoembolisation in patients with hepatocellular carcinoma: low-dose doxorubicin reduces post-embolisation syndrome without affecting survival—prospective interventional study

European Radiology Experimental ◽

10.1186/s41747-021-00204-6 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Ahmed A. Bessar ◽

Ahmed Farag ◽

Sameh M. Abdel Monem ◽

Fady M. Wadea ◽

Shady E. Shaker ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Low Dose ◽

Tumour Response ◽

Chemotherapeutic Agents ◽

Optimal Dosage ◽

Transarterial Chemoembolisation ◽

Group A ◽

Group B ◽

To Receive

Abstract Background No 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). Methods From 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. Results Twenty-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. Conclusion A lower dose of doxorubicin (50 mg) was associated with fewer PES symptoms compared with 100 mg, without effects on tumour response nor OS.

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Liver transplantation for hepatocellular carcinoma: The response to preoperative transarterial chemoembolisation can predict the outcome after orthotopic liver transplantation

Zeitschrift für Gastroenterologie ◽

10.1055/s-2005-869612 ◽

2005 ◽

Vol 43 (05) ◽

Author(s):

G Millonig ◽

IW Graziadei ◽

MC Freund ◽

W Jaschke ◽

S Stadlmann ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Orthotopic Liver Transplantation ◽

Transarterial Chemoembolisation

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Hypofractionated Stereotactic Radiotherapy after Transarterial Chemoembolisation Failure in an Unresectable Hepatocellular Carcinoma: A Case Presentation

Case Reports in Hepatology ◽

10.1155/2013/146215 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4

Author(s):

Francesco Fiorica ◽

Carlo Greco ◽

Sergio Boccia ◽

Sergio Sartori ◽

Antonio Stefanelli ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Stereotactic Radiotherapy ◽

Transarterial Chemoembolization ◽

Tumour Response ◽

Cancer Control ◽

Caucasian Woman ◽

Advanced Hepatocellular Carcinoma ◽

Case Presentation ◽

Hypofractionated Stereotactic Radiotherapy ◽

Unresectable Hepatocellular Carcinoma

Introduction. Transarterial chemoembolization is the first-line treatment in unresectable hepatocellular carcinoma. There is no standard treatment after transarterial chemoembolization failure. We report the case of a patient with advanced hepatocellular carcinoma who showed a complete response and a long cancer control with hypofractionated stereotactic radiotherapy after transarterial chemoembolization failure.Case Presentation. A 70-year-old Caucasian woman was treated with transarterial chemoembolization for advanced hepatocellular, but no cancer control was obtained. A hypofractionated stereotactic radiotherapy was planned delivering 40 Gy in 5 fractions. A dramatic reduction in alpha-fetoprotein was observed. Contrast-enhanced ultrasonography at 1 and 2 months showed large necrotic areas. Computerised tomography scan showed a 90% objective tumour response, then a complete remission at 3 and 6 months after treatment, respectively. Status of patient remained unchanged for 2 years.Conclusions. Hypofractionated stereotactic radiotherapy can improve survival and prognosis of unresectable hepatocellular carcinoma patient.

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Synchronous presentation of tuberculosis and hepatocellular carcinoma in a cirrhotic patient: a case report

Tropical Doctor ◽

10.1177/0049475519871133 ◽

2019 ◽

Vol 50 (1) ◽

pp. 71-74

Author(s):

Dhruvin Shah ◽

Ganesh P ◽

Shanmuganathan S ◽

AK Koushik

Keyword(s):

Hepatocellular Carcinoma ◽

Case Report ◽

Liver Disease ◽

Case Reports ◽

Disease Patient ◽

Immunocompromised Patients ◽

Liver Lesions ◽

Transarterial Chemoembolisation ◽

Common Opportunistic Infection ◽

Abdominal Lymphadenopathy

Tuberculosis (TB) is a common opportunistic infection which may be reactivated in immunocompromised patients. The incidence of hepatocellular carcinoma (HCC) is on the rise with healthcare resulting in increased longevity of people. Reactivation of TB has been reported with liver-directed therapies for HCC like transarterial chemoembolisation (TACE) and transarterial radio-embolisation (TARE). However, the co-occurrence of both TB and HCC in the same patient without any such history is rarely found. Only three isolated case reports have been published previously. We report the case of an elderly hepatitis C virus-related chronic liver disease patient who developed two different nodular liver lesions with multiple intra-abdominal lymphadenopathy, one such nodule being confirmed as HCC and another as TB along with nodal TB.

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