Predictive factors of transcatheter arterial chemoembolization for hepatocellular carcinoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4541-4541
Author(s):  
H. Ishii ◽  
J. Furuse ◽  
K. Nakachi ◽  
E. Suzuki ◽  
S. Shimizu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Factors ◽  
Transcatheter Arterial Chemoembolization ◽  
Objective Response ◽  
Gelatin Sponge ◽  
Iodized Oil ◽  
Multiple Tumors ◽  
Multiple Tumor ◽  
Solitary Tumor ◽  
Arterial Chemoembolization

4541 Background/Aim: Although transcatheter arterial chemoembolization (TACE) has been widely used for the treatment of unresectable hepatocellular carcinoma (HCC), the optimal indication of the TACE has not been fully elucidated. Methods: The treatment outcomes after TACE were analyzed retrospectively to determine predictive factors of anti-cancer effect on HCC. The patient (pts) selection criteria were: 1) admission between 1992 and 2005, 2) diagnosis of fresh HCC, 3) no extrahepatic metastasis and 4) primary treatment with TACE. TACE was performed by selectively introducing a catheter into the hepatic artery and injecting gelatin sponge particles following an emulsion consisting of 2–5 ml of iodized oil (Lipiodol) and 20–50 mg doxorubicin hydrochloride. Lipiodol accumulation in tumors was regarded as an indication of necrosis. We defined complete response (CR) as disappearance or 100% necrosis of all tumors, and partial response (PR) as more than 50% reduction and/or more than 50% necrosis. Results: There were 270 pts who fulfilled the above criteria. According to Japan Integrated Staging, the number of T1, T2, T3 and T4 was 10, 59, 171 and 30, respectively. There were 52 CRs, 113 PRs, 77 who remained SD and 28 who showed PD/NE. The median survival months of CR, PR, SD and PD/NE were 50, 30, 15 and 5, respectively, and there was a significant differences between them. The logistic regression analysis revealed tumor multiplicity and vascular invasion (VI) were significantly associated with the objective response (CR or PR). The response probability of patients with solitary tumor without VI was 85%, that with multiple tumors without VI was 63%, that with solitary tumor with VI was 33% and that with multiple tumors with VI was 16%. The small tumor (<5 cm) was another favorable factor which was significantly associated with CR. Among 231 patients without VI, the CR probability of patients with a solitary tumor <5 cm or >5 cm was 46% or 40%, respectively; although that of those with multiple tumors <5cm or >5cm was 21% or 5%, respectively. Conclusion: TACE is recommended for HCC patients without VI, and is optimally indicated for those with a solitary tumor or those with multiple tumor <5 cm among them. No significant financial relationships to disclose.

Study of the role of transcatheter arterial chemoembolization using iodized oil with and without gel foam for the management of hepatocellular carcinoma

2015 ◽  
Vol 28 (2) ◽  
pp. 447
Author(s):  
AymanAbd El-Halim Mohammed El-Gamal ◽  
HanySaid Sabry ◽  
UsamaaLotfy El-Abd ◽  
GamalSaad El Deeb ◽  
AymanMohamed El-Lehleh
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transcatheter Arterial Chemoembolization ◽  
Iodized Oil ◽  
Arterial Chemoembolization

scholarly journals Efficacy of Stereotactic Body Radiotherapy for Recurrent or Residual Hepatocellular Carcinoma after Transcatheter Arterial Chemoembolization

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Erhua Yao ◽  
Jinghong Chen ◽  
Xiaofang Zhao ◽  
Yinyan Zheng ◽  
Xianheng Wu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Stereotactic Body Radiotherapy ◽  
Palliative Treatment ◽  
Median Overall Survival ◽  
Transcatheter Arterial Chemoembolization ◽  
Response Rate ◽  
Objective Response ◽  
Overall Survival Rate ◽  
Arterial Chemoembolization

Aim. To evaluate the efficacy and toxicity of hypofractionated stereotactic body radiotherapy (SBRT) for patients with recurrent or residual hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). Methods. Between June 2008 and July 2015, thirty-three patients with HCC were treated by SBRT. There were 63 lesions in 33 patients. A total dose of 39–45 Gy/3–5 fractions was delivered to the 70–80% isodose line. Results. Objective response rate (CR + PR) was 84.8% at 6 months. The overall survival rate was 87.9%, 75.8%, 57.6%, and 45.5% at 6, 12, 18, and 24 months, respectively. Median overall survival was 19 months. At 3 months, AFP decreased by more than 75% in 51.5% of patients (17/33). Overall survival was significantly different (P<0.001) between the group of patients for whom AFP decreased more than 75% and the group for whom AFP decreased by less than 75%. The AFP-negative rate was 48.5% (16/33) after 6 months. Eight patients (24.2%) had grade 1-2 transient fatigue, and 11 patients (33.3%) had grade 1-2 gastrointestinal reactions within 1 month. Conclusion. SBRT is a promising noninvasive and palliative treatment with acceptable toxicity for recurrent or residual HCC after TACE.

A randomized phase II trial of a drug eluting bead in the treatment of hepatocellular carcinoma by transcatheter arterial chemoembolization

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4523-4523 ◽  
Author(s):  
R. Lencioni ◽  
K. Malagari ◽  
T. Vogl ◽  
F. Pilleul ◽  
A. Denys ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Response ◽  
Transcatheter Arterial Chemoembolization ◽  
Objective Response ◽  
Intermediate Stage ◽  
Curative Treatment ◽  
Tace Group ◽  
Conventional Tace ◽  
Drug Eluting ◽  
Arterial Chemoembolization

4523 Background: Transcatheter arterial chemoembolization (TACE) has been shown to offer a survival benefit for patients with intermediate-stage hepatocellular carcinoma (HCC). A widely accepted TACE regimen includes the administration of a doxorubicin-in-oil emulsion followed by gelatine sponge particles. Recently, a drug-eluting bead (DEB) has been developed to enhance drug delivery to the tumor and reduce its systemic availability. Purpose of this randomized trial was to compare conventional TACE with DEB-TACE for the treatment of intermediate-stage HCC in patients with cirrhosis. Methods: Two hundred and twelve patients (185 males and 27 females; mean age, 67 years) with Child-Pugh A or B liver cirrhosis and large and/or multinodular, unresectable HCC were randomized to receive DEB-TACE (DC Bead; Biocompatibles, UK) uploaded with doxorubicin or conventional TACE with doxorubicin, lipiodol, and gelatin sponge particles. Randomization was stratified according to Child Pugh status (A or B), performance status (ECOG 0 or 1), bilobar disease (yes or no) and prior curative treatment (yes or no). Tumor response at 6 months was the primary study endpoint. An independent, blinded review of magnetic resonance imaging studies was conducted to assess tumor response according to amended RECIST criteria. Results: DEB-TACE with doxorubicin showed a higher rate of complete response, objective response and disease control compared with conventional TACE (27% vs 22%; 52% vs 44%; and 63% vs 52%, respectively; p>0.05). Patients with Child Pugh B, ECOG 1, bilobar disease and recurrence following curative treatment showed a significant increase in objective response (p=0.038) compared to the control. There was a marked reduction in serious liver toxicity in patients treated with DEB-TACE. The rate of doxorubicin related side effects was significantly lower (p=0.0001) in the DEB-TACE group compared with the conventional TACE group. Conclusions: DEB-TACE with doxorubicin is safe and effective in the treatment of intermediate-stage HCC and may offer benefit to patients with more advanced disease. No significant financial relationships to disclose.

scholarly journals Conventional Transarterial Chemoembolization Versus Drug-Eluting Beads in Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6172
Author(s):  
Khalid I. Bzeizi ◽  
Mohammad Arabi ◽  
Negar Jamshidi ◽  
Ali Albenmousa ◽  
Faisal M. Sanai ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Partial Response ◽  
Transcatheter Arterial Chemoembolization ◽  
Objective Response ◽  
Pooled Analysis ◽  
All Cause Mortality ◽  
Drug Eluting Beads ◽  
Drug Eluting ◽  
Tace Treatment ◽  
Arterial Chemoembolization

Hepatocellular carcinoma (HCC) occurs in nearly three-quarters of all primary liver cancers, with the majority not amenable to curative therapies. We therefore aimed to re-evaluate the safety, efficacy, and survival benefits of treating patients with drug-eluting beads transcatheter arterial chemoembolization (DEB-TACE) compared to the conventional transcatheter arterial chemoembolization (C-TACE). Several databases were searched with a strict eligibility criterion for studies reporting on adult patients with unresectable or recurrent HCC. The pooled analysis included 34 studies involving 4841 HCC patients with a median follow-up of 1.5 to 18 months. There were no significant differences between DEB-TACE and C-TACE with regard to complete response, partial response and disease stability. However, disease control (OR: 1.42 (95% CI (1.03,1.96) and objective response (OR: 1.33 (95% CI (0.99, 1.79) were significantly more effective for DEB-TACE treatment with fewer severe complications and all-cause mortality. The pooled-analysis did not find superiority of DEB-TACE in complete or partial response, disease stability, controlling disease progression, and 30 day or end-mortality. However, results showed that DEB-TACE is associated with a better objective response, disease control, and lower all-cause mortality with severe complications compared to C-TACE treatment. Given that the safety outcomes are based on limited studies with a potential for bias, there was no clear improvement of DEB-TACE over C-TACE treatment.

Detection of Viable Tumor Cells in Hepatocellular Carcinoma following Transcatheter Arterial Chemoembolization with Iodized Oil

1993 ◽  
Vol 34 (4) ◽  
pp. 399-403 ◽  
Author(s):  
T. Murakami ◽  
H. Nakamura ◽  
S. Hori ◽  
K. Tomoda ◽  
T. Mitani ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Mr Imaging ◽  
Early Phase ◽  
Transcatheter Arterial Chemoembolization ◽  
Late Phase ◽  
Gadopentetate Dimeglumine ◽  
Liver Parenchyma ◽  
Iodized Oil ◽  
Delayed Phase ◽  
Arterial Chemoembolization

To evaluate the effect of transcatheter arterial chemoembolization (TACE) with iodized oil for hepatocellular carcinoma (HCC), dynamic turbo-fast low angle shot (turbo-FLASH) (TR/TE/flip angle/TI, 8.5/4.6/10/200) MR imaging with gadopentetate dimeglumine was performed in 10 patients with HCC after TACE with iodized oil and before partial hepatectomy. Immediately after 0.05 mmol/kg b.w. of gadopentetate dimeglumine was administered intravenously, 10 images were obtained in the first 20 s (early phase). Then, one image every 30 s from 1 to 3 min (late phase), and images at 5 min and 7 min (delayed phase) were obtained serially. In the early phase, HCC showed no enhancement in 5 patients, partial hyperintense enhancement in 4, and total hyperintense enhancement in one. Viable regions of the tumor, evaluated at histopathology, showed hyperintense enhancement relative to the surrounding liver parenchyma in the early phase, while necrotic regions showed no enhancement. Both viable and necrotic regions showed lower signal intensities than the surrounding liver parenchyma in both late and delayed phases. By using dynamic turbo-FLASH MR imaging, we were able to accurately evaluate the effect of TACE with iodized oil for HCC in 8 of the 10 patients. In 2 patients, in whom small viable cells were seen in the HCC, viable regions could not be detected with our technique. It is concluded that turbo-FLASH dynamic MR imaging was useful for evaluating the effect of TACE for HCC.

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