Efficacy and Safety of Supplemental Transarterial Chemoembolization Through Extrahepatic Collateral Arteries with Drug-eluting Beads: Treatment for Unresectable Hepatocellular Carcinoma
Open Access
- 1 January 2020
- journal article
- research article
- Published by Taylor & Francis Ltd in Drug Design, Development and Therapy
- Vol. 14, 5029-5041
- https://doi.org/10.2147/DDDT.S266470
Abstract
Purpose: To evaluate the therapeutic efficacy and safety of supplement transarterial chemoembolization (TACE) with drug-eluting beads TACE (DEB-TACE) through extrahepatic collateral (EHC) arteries for the treatment of hepatocellular carcinoma (HCC). Patients and Methods: In this retrospective study, 61 unresectable HCC patients with treatment-naive EHC blood supplies who received TACE from January 2016 to March 2019 were enrolled; of these patients, 42 (68.9%) received DEB-TACE, and 19 (31.1%) received cTACE. The hepatic tumor feeding arteries were treated in the same TACE session if it presented. The tumor response, time-to-progression (TTP), and overall survival (OS) were analyzed. Safety was assessed based on the occurrence of liver function deterioration and major complications within three months after TACE. Results: DEB-TACE showed better efficacy than cTACE in the disease control rate (p=0.001), overall response rate (p=0.005), the TTP (eight months vsthree months, p=0.002) and the OS (23.8 months vs nine months, p=0.045). Nine patients in the DEB-TACE group and one patient in the cTACE group were downstaged to resection or liver transplantation (21.4% vs 5.3%, p=0.151). DEB-TACE and cTACE have no difference in the acute and chronic liver toxicity. With regard to complications, there was no significant difference in the occurrence of both major (16.7% vs 21.1%, p=0.72) and minor (57.1% vs 47.4%, p=0.48) complications between DEB-TACE and cTACE. Conclusion: DEB-TACE through EHC arteries has a potential therapeutic effect in the treatment of unresectable HCC, with comparable safety compared with cTACE.This publication has 36 references indexed in Scilit:
- Comparative study between doxorubicin-eluting beads and conventional transarterial chemoembolization for treatment of hepatocellular carcinomaJournal of Hepatology, 2012
- Transcatheter Arterial Embolization of Hepatic Arteriovenous Shunts in Patients with Hepatocellular CarcinomaSeminars in Interventional Radiology, 2012
- Radiopaque Drug-Eluting Beads for Transcatheter Embolotherapy: Experimental Study of Drug Penetration and Coverage in SwineJournal of Vascular and Interventional Radiology, 2012
- Chemoembolization Endpoints: Effect on Survival Among Patients With Hepatocellular CarcinomaAmerican Journal of Roentgenology, 2011
- Modified RECIST (mRECIST) Assessment for Hepatocellular CarcinomaSeminars in Liver Disease, 2010
- Prospective Randomized Study of Doxorubicin-Eluting-Bead Embolization in the Treatment of Hepatocellular Carcinoma: Results of the PRECISION V StudyCardioVascular and Interventional Radiology, 2009
- Transcatheter Therapy for Hepatic Malignancy: Standardization of Terminology and Reporting CriteriaJournal of Vascular and Interventional Radiology, 2009
- Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: Prospective Assessment of the Right Inferior Phrenic Artery with C-arm CTJournal of Vascular and Interventional Radiology, 2009
- Chemoembolization of hepatocellular carcinoma with drug eluting beads: Efficacy and doxorubicin pharmacokineticsJournal of Hepatology, 2007
- Effect of arterial administration of high-molecular-weight anticancer agent SMANCS with lipid lymphographic agent on hepatoma: a preliminary reportEuropean Journal of Cancer and Clinical Oncology, 1983