Comparison of lipiodol infusion and drug-eluting beads transarterial chemoembolization of hepatocellular carcinoma in a real-life setting
| Autor: | Rimma Axelsson, Per Stål, Torkel B. Brismar, Staffan Wahlin, Mojgan Haji, Johan Teiler, Amar Karalli, Elin Seth |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Carcinoma Hepatocellular Nausea Gastroenterology 03 medical and health sciences 0302 clinical medicine Drug Delivery Systems Ethiodized Oil Internal medicine Medicine Humans Chemoembolization Therapeutic Adverse effect Survival analysis Aged Retrospective Studies Venous Thrombosis Antibiotics Antineoplastic business.industry Proportional hazards model Liver Neoplasms Middle Aged Sorafenib medicine.disease Survival Analysis Microspheres Portal vein thrombosis Treatment Outcome Tolerability 030220 oncology & carcinogenesis Hepatocellular carcinoma Multivariate Analysis Lipiodol 030211 gastroenterology & hepatology Female medicine.symptom business medicine.drug |
| Zdroj: | Scandinavian journal of gastroenterology. 54(7) |
| ISSN: | 1502-7708 |
| Popis: | Aim: Doxorubicin-eluting beads transarterial chemoembolization (DEB-TACE) is reported to improve survival and tolerability when compared with conventional lipiodol-TACE (cTACE) for the treatment of hepatocellular carcinoma (HCC). The aim of this study was to evaluate tolerability and long-term survival in patients treated with cTACE or DEB-TACE in a real-life setting. Methods: Incidence of adverse events and overall survival in HCC patients treated with either cTACE or DEB-TACE at Karolinska University Hospital 2004-2012 were analyzed retrospectively. Median follow-up was 7.1 years. Patients were censored when transplanted or at the end of follow-up. Patients receiving both cTACE and DEB-TACE, or treated with resection or ablation post-TACE were excluded from the survival analysis. Results: A total of 202 patients (76 cTACE and 126 DEB-TACE) were eligible for analysis of adverse events, and 179 patients (69 cTACE and 110 DEB-TACE) were included in the survival analysis. cTACE patients were younger and had fewer tumors but higher BCLC stage than DEB-TACE. Child-Pugh and ECOG performance status were similar between groups. Adverse events (abdominal pain, nausea and vomiting, fever, fatigue) were significantly less common in the DEB-TACE group. Median survival was 17.1 months in the cTACE group and 19.1 months in the DEB-TACE (NS). In multivariate Cox regression analysis, portal vein thrombosis and tumor size were associated with increased, and sorafenib treatment post-TACE with decreased mortality. Conclusion: In this retrospective real-life analysis, DEB-TACE had better tolerability compared to cTACE, but overall survival did not differ between the two treatments. Portal vein thrombosis, tumor size and sorafenib treatment after TACE influence survival. |
| Databáze: | OpenAIRE |
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