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Conventional versus doxorubicin-eluting bead transarterial chemoembolization for hepatocellular carcinoma.

Authors :
Sacco R
Bargellini I
Bertini M
Bozzi E
Romano A
Petruzzi P
Tumino E
Ginanni B
Federici G
Cioni R
Metrangolo S
Bertoni M
Bresci G
Parisi G
Altomare E
Capria A
Bartolozzi C
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.)

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