Conventional versus drug-eluting beads chemoembolization for infiltrative hepatocellular carcinoma: a comparison of efficacy and safety

Autor: Zishu Zhang, Yu-Dong Xiao, Cong Ma, Hui-zhou Li
Rok vydání: 2019
Předmět:
Adult
Male
Cancer Research
medicine.medical_specialty
Abdominal pain
Carcinoma
Hepatocellular

Side effect
lcsh:RC254-282
Gastroenterology
030218 nuclear medicine & medical imaging
03 medical and health sciences
Chemoembolization
therapeutic

Drug Delivery Systems
Ethiodized Oil
0302 clinical medicine
Internal medicine
Ascites
Genetics
medicine
Humans
Aged
Retrospective Studies
Aged
80 and over

Antibiotics
Antineoplastic

business.industry
Liver Neoplasms
Retrospective cohort study
Common Terminology Criteria for Adverse Events
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
Microspheres
Treatment Outcome
Oncology
Tolerability
Doxorubicin
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Drug Evaluation
Population study
Female
medicine.symptom
business
Research Article
Zdroj: BMC Cancer
BMC Cancer, Vol 19, Iss 1, Pp 1-10 (2019)
ISSN: 1471-2407
Popis: Background To compare the efficacy and safety between conventional transarterial chemoembolization (cTACE) and drug-eluting beads TACE (DEB-TACE) in patients with infiltrative hepatocellular carcinoma (iHCC). Methods A total of 89 iHCC patients who were treated with either cTACE (n = 33) or DEB-TACE (n = 56) between April 2013 and September 2017 were included in this retrospective study. Patients with the situations that might have a poor outcome were defined as advanced disease including Child-Pugh class B, bilobar lesions, tumor size greater than 10 cm, ECOG 1–2, tumor burden of 50–70%, and the presence of ascites, arterioportal shunt (APS), and portal venous tumor thrombus (PVTT). The tumor response was measured 1-month and 3-month after the procedure. Progression-free survival (PFS) was calculated. Toxicity was graded by Common Terminology Criteria for Adverse Events v5.0 (CTCAE v5.0). The differences in tumor response, PFS, and toxicity were compared between the DEB-TACE group and cTACE group. Results At 1-month and 3-month after the procedure, the objective response rate (ORR) in the overall study population was similar in DEB-TACE group and cTACE group. The disease control rate (DCR), at 1-month after the procedure, was significantly higher in the patients treated with DEB-TACE relative to those treated with cTACE (P = 0.034), while after 3 months, the difference did not differ between two groups. DEB-TACE showed a higher DCR than cTACE in patients with tumor size greater than 10 cm (P = 0.036) or associated with APS (P = 0.030) at 1-month after the procedure, while after 3 months, the difference was only noted in patients with APS (P = 0.036). The median PFS in DEB-TACE group was 96 days, while in cTACE group was 94 days, and there was no difference in PFS between two groups (P = 0.831). In the side effect analysis, abdominal pain (P = 0.034) and fever (P = 0.009) were more frequently present in the cTACE group than DEB-TACE group, but there was no difference in high grade liver toxicity between the two groups. Conclusions Compared to cTACE, DEB-TACE offers slightly better DCR and tolerability for iHCC patients, particularly in patients associated with APS and large tumor size. However, DEB-TACE does not provide higher PFS than cTACE.
Databáze: OpenAIRE