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Conventional versus doxorubicin-eluting bead transarterial chemoembolization for hepatocellular carcinoma.
- Source :
-
Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2011 Nov; Vol. 22 (11), pp. 1545-52. Date of Electronic Publication: 2011 Aug 16. - Publication Year :
- 2011
-
Abstract
- Purpose: To compare short- and long-term clinical outcomes after conventional transarterial chemoembolization and drug-eluting bead (DEB) transarterial chemoembolization in hepatocellular carcinoma (HCC).<br />Materials and Methods: Patients with unresectable HCC unsuitable for ablative therapies were randomly assigned to undergo conventional or DEB chemoembolization. The primary endpoints of the study were safety, toxicity, and tumor response at 1 month. Secondary endpoints were number of repeated chemoembolization cycles, time to recurrence and local recurrence, time to radiologic progression, and survival.<br />Results: In total, 67 patients (mean age, 70 y ± 7.7) were evaluated. Mean follow-up was 816 days ± 361. Two periprocedural major complications occurred (2.9%) that were treated by medical therapy without the need for other interventions. A significant increase in alanine aminotransferase levels 24 hours after treatment was reported, which was significantly greater after conventional chemoembolization (n = 34) than after DEB chemoembolization (n = 33; preprocedure, 60 IU ± 44 vs 74 IU ± 62, respectively; at 24 h, 216 IU ± 201 vs 101 IU ± 89, respectively; P = 0.007). No other differences were observed in liver toxicity between groups. At 1 month, complete and partial tumor response rates were 70.6% and 29.4%, respectively, in the conventional chemoembolization group and 51.5% and 48.5%, respectively, in the DEB chemoembolization group. No differences were observed between groups in time to recurrence and local recurrence, radiologic progression, and survival.<br />Conclusions: Conventional chemoembolization and DEB chemoembolization have a limited impact on liver function on short- and long-term follow-up and are associated with favorable clinical outcomes.<br /> (Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Antibiotics, Antineoplastic adverse effects
Carcinoma, Hepatocellular blood supply
Carcinoma, Hepatocellular diagnostic imaging
Carcinoma, Hepatocellular mortality
Carcinoma, Hepatocellular secondary
Chi-Square Distribution
Disease-Free Survival
Doxorubicin adverse effects
Drug Carriers
Female
Humans
Italy
Kaplan-Meier Estimate
Liver Neoplasms blood supply
Liver Neoplasms diagnostic imaging
Liver Neoplasms mortality
Liver Neoplasms pathology
Male
Middle Aged
Neoplasm Recurrence, Local
Prospective Studies
Risk Assessment
Risk Factors
Survival Rate
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Tumor Burden
Antibiotics, Antineoplastic administration & dosage
Carcinoma, Hepatocellular drug therapy
Chemoembolization, Therapeutic adverse effects
Chemoembolization, Therapeutic mortality
Doxorubicin administration & dosage
Hepatic Artery
Liver Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1535-7732
- Volume :
- 22
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Journal of vascular and interventional radiology : JVIR
- Publication Type :
- Academic Journal
- Accession number :
- 21849247
- Full Text :
- https://doi.org/10.1016/j.jvir.2011.07.002