Transarterial chemoembolization with drug-eluting beads in patients with hepatocellular carcinoma: response analysis with mRECIST.

Autor:	Domaratius C; Department of Radiology, University Hospital Jena, Friedrich Schiller University, Jena, Germany., Settmacher U; Department of General, Visceral and Vascular Surgery, University Hospital Jena, Friedrich Schiller University, Jena, Germany., Malessa C; Department of General, Visceral and Vascular Surgery, University Hospital Jena, Friedrich Schiller University, Jena, Germany., Teichgräber U; Department of Radiology, University Hospital Jena, Friedrich Schiller University, Jena, Germany.
Jazyk:	angličtina
Zdroj:	Diagnostic and interventional radiology (Ankara, Turkey) [Diagn Interv Radiol] 2021 Jan; Vol. 27 (1), pp. 85-93.
DOI:	10.5152/dir.2020.19439
Abstrakt:	Purpose: According to the Barcelona Clinic Liver Cancer (BCLC) staging classification, transarterial chemoembolization (TACE) is the treatment of choice for intermediate hepatocellular carcinoma (HCC). Thereby, the use of drug-eluting beads (DEB) as embolic agents has been recently established in clinical practice. The aim of this study was to evaluate tumor response after DEB-TACE. Methods: This retrospective study was approved by the institutional ethics committee. Overall, 89 patients with HCC (Child Pugh A or B) receiving DEB-TACE as palliative treatment option or as bridging before liver transplantation were included in the study. Tumor response was assessed by modified response evaluation criteria in solid tumors (mRECIST) and a tumor growth rate. Survival analysis was performed using Kaplan-Meier estimator with log-rank testing and Cox proportional hazards. Results: A total of 188 TACE procedures were performed between 2006 and 2010. After the last intervention, 18% achieved complete response, 45% achieved partial response, 28% had stable disease and 9% had progressive disease. Using the tumor growth rate, 90% of all patients showed a tumor reduction between first and final response evaluation. The 6-month, 1-, 2- and 3-year overall survival rates were 86.5%, 67.4%, 47.2%, and 33.7%, with a median survival of 45, 24, 15, and 14 months for complete response, partial response, stable disease, and progressive disease, respectively. Tumor reduction showed a positive effect on survival. Conclusion: DEB-TACE offers conclusive response results with mRECIST and proves a strong tendency of tumor reduction on survival benefits. Therefore, tumor growth rate represents a possible parameter to predict survival.
Databáze:	MEDLINE
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