DSM-TACE of HCC: Evaluation of Tumor Response in Patients Ineligible for Other Systemic or Loco-Regional Therapies.

Autor:	Haubold J; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany., Reinboldt MP; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany., Wetter A; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany., Li Y; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany., Ludwig JM; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany., Lange C; Department of Gastroenterology and Hepatology, University Hospital Essen, Germany., Wedemeyer H; Department of Gastroenterology and Hepatology, University Hospital Essen, Germany., Schotten C; Department of Gastroenterology and Hepatology, University Hospital Essen, Germany., Umutlu L; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany., Theysohn J; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany.
Jazyk:	angličtina
Zdroj:	RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin [Rofo] 2020 Sep; Vol. 192 (9), pp. 862-869. Date of Electronic Publication: 2020 Mar 04.
DOI:	10.1055/a-1111-9955
Abstrakt:	Purpose:  To analyze tumor response, survival and safety in patients with non-resectable hepatocellular carcinoma (HCC) treated with transarterial hepatic chemoembolization using degradable starch microspheres (DSM-TACE) combined with doxorubicin who had no local interventional or systemic therapy alternative according to an interdisciplinary conference. Materials and Methods:  In this retrospective study, 28 patients (23 male, 5 female, median age 67 years) with unresectable HCC, serum bilirubin levels < 3 mg/dl and contraindications to Sorafenib, RFA, SIRT or cTACE were included. DSM-TACE was performed using Embocept ® S (15 ml) and doxorubicin (50 mg/25 ml) three times every 4-6 weeks. Patients were initially staged using the Barcelona Clinic Liver Cancer System (BCLC). Basic liver function was evaluated with the MELD-score. Tumor response was assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Results:  DSM-TACE could be technically successfully performed in all 28 patients. At control imaging after three treatments, the overall rates of complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) were 14.3 %, 25 %, 39.3 % and 21.4 %, respectively, according to mRECIST. With regard to BCLC stages, the results were as follows (CR, PR, PD): BCLC A (n = 8): 7.1 %, 7.1 %, 10.7 %, 1.2 %; BCLC B (n = 12): 0 %, 10.7 %, 17.9 %, 14.3 %; BCLC C (n = 5): 0 %, 3.6 %, 10.7 %, 3.6 %; BCLC D (n = 3): 3.6 %, 3.6 %, 0 %, 3.6 %. According to this, DSM-TACE showed an overall good median survival of 682 days, although the patients' survival was strictly dependent on BCLC stage. Conclusion:  DSM-TACE is a safe and promising treatment alternative for patients with unresectable HCC who are ineligible for other loco-regional therapies. Key Points:   · DSM-TACE is a safe treatment alternative for patients ineligible for other local or systemic treatments.. · DSM-TACE did not influence the MELD-score in our study population.. · Patients treated with DSM-TACE showed an overall good median survival of 682 days, strictly dependent on BCLC stage.. Citation Format: · Haubold J, Reinboldt MP, Wetter A et al. DSM-TACE of HCC: Evaluation of Tumor Response in Patients Ineligible for Other Systemic or Loco-Regional Therapies. Fortschr Röntgenstr 2020; 192: 862 - 869. Competing Interests: Prof. Dr. Jens M. Theysohn has given paid lectures for the company Pharmacept in the last 3 years. The authors declare that they have no further conflict of interest. (© Georg Thieme Verlag KG Stuttgart · New York.)
Databáze:	MEDLINE
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