DEB TACE for Intermediate and advanced HCC - Initial Experience in a Brazilian Cancer Center.

Autor: Luz JH; Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Praça Cruz Vermelha 23, Centro, Rio de Janeiro, CEP 20230-130, Brazil. jhugoluz@gmail.com., Luz PM; National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil., Martin HS; Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Praça Cruz Vermelha 23, Centro, Rio de Janeiro, CEP 20230-130, Brazil., Gouveia HR; Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Praça Cruz Vermelha 23, Centro, Rio de Janeiro, CEP 20230-130, Brazil., Levigard RB; Department of Interventional Radiology, Radiology Division, Hospital Federal de Bonsucesso, Avenida Londres, 616, Bonsucesso, Rio de Janeiro, 21041-030, Brazil., Nogueira FD; Department of Interventional Radiology, Radiology Division, Hospital Federal de Bonsucesso, Avenida Londres, 616, Bonsucesso, Rio de Janeiro, 21041-030, Brazil., Rodrigues BC; Department of Interventional Radiology, Radiology Division, Hospital Federal de Ipanema, Rua Antônio Parreiras, 67, Ipanema, Rio de Janeiro, 22411-020, Brazil., de Miranda TN; Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Praça Cruz Vermelha 23, Centro, Rio de Janeiro, CEP 20230-130, Brazil., Mamede MH; Department of Anatomy and Radiology, Full Professor, Medicine School - UFMG, Avenida Presidente Antônio Carlos, 6627 Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
Jazyk: angličtina
Zdroj: Cancer imaging : the official publication of the International Cancer Imaging Society [Cancer Imaging] 2017 Feb 06; Vol. 17 (1), pp. 5. Date of Electronic Publication: 2017 Feb 06.
DOI: 10.1186/s40644-017-0108-6
Abstrakt: Background: According to Barcelona Clinic Liver Cancer classification transarterial chemoembolization is indicated in patients with Hepatocellular Carcinoma in the intermediate stage. Drug-eluting microspheres can absorb and release the chemotherapeutic agent slowly for 14 days after its intra-arterial administration. This type of transarterial chemoembolization approach appears to provide at least equivalent effectiveness with less toxicity.
Methods: This is a prospective, single-center study, which evaluated 21 patients with intermediate and advanced hepatocellular carcinoma who underwent transarterial chemoembolization with drug-eluting microspheres. The follow up period was 2 years. Inclusion criteria was Child-Pugh A or B liver disease patients, intermediate or advanced hepatocellular carcinoma and performance status equal or below 2. Transarterial chemoembolization with drug-eluting microspheres was performed at 2-month intervals during the first two sessions. The third and subsequent sessions were performed according to the image findings on follow-up, on a "demand schedule". Tumor response and time to progression were evaluated along the two-year follow up period.
Results: Of the 21 patients 90% presented with liver cirrhosis, 62% had Barcelona Clinic Liver Cancer stage B and 38% had Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma. Average tumor size was 6.9 cm. The average number of Transarterial chemoembolization with drug-eluting microspheres procedures was 3 with a total of 64 sessions. The predominant toxicity was mild. Liver function was not significantly affected in most patients. Two deaths occurred within 90 days after Transarterial chemoembolization with drug-eluting microspheres (ischemic hepatitis and hydropic decompensation). Technical success was achieved in 63 of 64 procedures. The mean hospital stay was 1.5 days. The progression free and overall survival at 1 and 2 years were 73.0% and 37.1%, 73.7% and 41.6%, respectively.
Conclusion: Transarterial chemoembolization with drug-eluting microspheres is able to deliver significant tumor response and progression free survival rate with acceptable toxicity. Larger studies are needed to identify exactly which subset of advanced hepatocellular patients may benefit from this treatment.
Trial Registration: study ID ISRCTN16295622. Registered October 14th 2016. Retrospectively registered. Website registration: http://www.isrctn.com/ISRCTN16295622.
Databáze: MEDLINE
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