Safety and efficacy of transcatheter arterial chemoembolization with embospheres in treatment of hepatocellular carcinoma

J Dig Dis. 2017 Jan;18(1):31-39. doi: 10.1111/1751-2980.12435.

Abstract

Objective: To investigate the safety and efficacy of transcatheter arterial chemoembolization (TACE) with embospheres for the treatment of unresectable hepatocellular carcinoma (HCC).

Methods: Patients with unresectable HCC who were treated with TACE followed by embosphere treatment (Embo-TACE) or conventional TACE (cTACE) between May 2010 and March 2014 were retrospectively included in this study. The Embo-TACE group received lipiodol and chemotherapeutic agent emulsion, followed by embospheres. The cTACE group received lipiodol and chemotherapeutic agent emulsion, followed by gelatin sponge pellets. Time to progression (TTP), overall survival (OS), overall response rate (ORR), and safety were compared between the two groups. Univariate and multivariate regression analyses of the factors affecting survival were conducted.

Results: The median TTP and OS in the Embo-TACE group were significantly longer than those in the cTACE group (TPP: 7.0 months vs 5.4 months, P = 0.035; OS: 15 months vs 12 months, P = 0.032). Seven days after the first TACE treatment, alanine aminotransferase level was higher in the cTACE group than in the Embo-TACE group (P = 0.015). The ORR did not significantly differ between the two groups (P = 0.827). Additional therapy and local responses one month after the first TACE treatment were associated with OS.

Conclusions: Embo-TACE resulted in a significant improvement in TTP and OS for patients with unresectable HCC, compared with cTACE. Furthermore, Embo-TACE was better tolerated. Additional therapy and local responses one month after the first TACE were independent prognostic factors for OS.

Keywords: embosphere; hepatocellular carcinoma; survival; transcatheter arterial chemoembolizationtrisacryl gelatin microsphere.

MeSH terms

  • Acrylic Resins / adverse effects
  • Acrylic Resins / therapeutic use*
  • Acute Lung Injury / etiology
  • Adolescent
  • Adult
  • Aged
  • Angiography
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / adverse effects
  • Chemoembolization, Therapeutic / methods*
  • Ethiodized Oil / adverse effects
  • Ethiodized Oil / therapeutic use
  • Female
  • Gelatin / adverse effects
  • Gelatin / therapeutic use*
  • Hepatic Artery / diagnostic imaging
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / therapy*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult

Substances

  • Acrylic Resins
  • trisacryl gelatin microspheres
  • Ethiodized Oil
  • Gelatin