Drug-eluting bead loaded with doxorubicin versus conventional Lipiodol-based transarterial chemoembolization in the treatment of hepatocellular carcinoma

Song, Myeong Jun; Park, Chung-Hwa; Kim, Jin-Dong; Kim, Hee Yeon; Bae, Si Hyun; Choi, Jong Young; Yoon, Seung Kew; Chun, Ho Jong; Choi, Byung Gil; Lee, Hae Giu

doi:10.1097/meg.0b013e328346d505

Cited by 63 publications

(56 citation statements)

References 20 publications

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“…A recent case-control study conducted in Asian patients with HCC confirmed higher ORR for DEB-TACE as compared with conventional TACE. 29 The added value of chemotherapeutic agent over bland embolic microspheres has been demonstrated by a randomized trial comparing beads loaded with doxorubicin versus bland embolization performed with an embolic microsphere with similar characteristics. The rate of tumor progression at 12 months was significantly lower in the DEB arm than in the bland embolization arm (46% versus 78%, p ¼ 0.002), and time to progression (TTP) increased from 36.2 AE 9.0 weeks to 42.4 AE 9.5 weeks (p ¼ 0.008).…”

Section: Deb-tacementioning

confidence: 99%

Chemoembolization for Hepatocellular Carcinoma

Lencioni

2012

Seminars in Oncology

104

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Section: Deb-tacementioning

confidence: 99%

Chemoembolization for Hepatocellular Carcinoma

Lencioni

2012

Seminars in Oncology

104

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“…In an Asian case-control study, Song et al [23] reported that patients with larger (> 5 cm) or multiple HCC tumors responded better to DEBDOX-TACE than to cTACE. Given its favorable clinical response and potential to reduce complications, TACE regimens utilizing DEBDOX-TACE are increasingly being considered as first-line treatment tools for HCC [24-27]. Even though treatment efficacy of DEBs in advanced-stage HCC (i.e., BCLC stage C) has not been extensively studied, preliminary experience suggests that patients with Child-Pugh class A disease with advanced disease may fare better with aggressive locoregional treatment in the form of TACE with DEBs than with systemic monotherapy with sorafenib.…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary Taiwan Consensus Recommendations for the Use of DEBDOX-TACE in Hepatocellular Carcinoma Treatment

et al. 2018

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Transarterial chemoembolization (TACE) is the first-line treatment in patients with unresectable hepatocellular carcinoma (HCC). In recent years, there has been increasing clinical evidence that drug-eluting beads provide a combined ischemic and cytotoxic effect that may be superior to conventional TACE, with low systemic toxicity. The therapeutic value of TACE performed using the embolic microsphere DC Bead loaded with doxorubicin (drug-eluting bead doxorubicin [DEBDOX]) has been shown by several randomized controlled trials. Since Lencioni et al. [Cardiovasc Intervent Radiol 2012; 35: 980–985] published the first widely accepted technical recommendations on HCC embolization with DEBDOX-TACE in 2012, new studies have contributed to a better understanding of when and how to apply this new therapeutic modality, and they have yet to be incorporated into an updated guideline. Additionally, differences in the underlying liver pathology and practice of transcatheter embolization between Asian and Western populations have not been adequately addressed, and there remain significant variations in the TACE protocols adopted in different parts of the world. These mainly revolve around the number and type of chemotherapeutic agents used, type of embolic material, reliance on Lipiodol, and selectivity of catheter positioning. As a result of these issues, it has been difficult to interpret and compare results obtained from different centers in a systematic fashion. To address these concerns, we convened a panel of experts specializing in different aspects of HCC treatment to craft an updated set of recommendations that better reflect recent clinical experiences and are tailored to the use of DEBDOX-TACE in Taiwan. The conclusions of this expert panel are described in the following article.

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“…pacientų -C. Pagal Barselonos algoritmą pacientams su Childo ir Pugho C funkcine klase TACE neturėtų būti taikoma. Didžioji dalis tyrimų tokių pacientų neįtraukė [9,19,20,23]. JAV atliktame tyrime dalyvavo 22,6 proc.…”

Section: Rezultatų Aptarimasunclassified

“…Kituose tyrimuose, kuriuose radiologinis atsakas buvo vertintas taip pat pagal mRECIST kriterijus, objektyvus atsakas pasiektas atitinkamai 85 proc. [23] ir 81,6 proc. [20] pacientų.…”

Section: Rezultatų Aptarimasunclassified

Hepatoceliulinės Karcinomos Gydymo Transarterine Chemoembolizacija Doksorubicinu Impregnuotomis Mikrosferomis (Deb Tace) Lietuvos Sveikatos Mokslų Universiteto Ligoninėje Kauno Klinikose Analizė

Pranculis

Kievišas

Kievišienė

et al. 2015

Medicinos Teorija Ir Praktika

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SANTRAUKAReikšminiai žodžiai: transarterinė chemoembolizacija (TACE), transarterinė chemoembolizacija doksorubicinu impregnuotomis mikrosferomis (DEB TACE), hepatoceliulinė karcinoma (HCC). Hepatoceliulinė karcinoma (HCC) -dažniausias pirminis kepenų navikas. Kepenų rezekcija, transplantacija arba radiodaž-ninė abliacija galimos tik kai yra labai ankstyvos arba ankstyvos vėžio stadijos. Transarterinė chemoembolizacija (TACE) yra pirmo pasirinkimo gydymo metodas daugiažidininiu kepenų vėžiu sergantiems pacientams. Tikslas. Išanalizuoti transarterinės chemoembolizacijos doksorubicinu impregnuotomis mikrosferomis (DEB TACE) būdu dėl hepatoceliulinės karcinomos gydytų pacientų gydymo išeitis Lietuvos sveikatos mokslų universiteto ligoninėje Kauno klinikose (LSMUL KK).Tyrimo medžiaga ir metodai. Atliktas retrospektyvinis tyrimas, įtraukta 20 HCC sergančių ir DEB TACE gydytų pacientų. Visiems pacientams nuo 2012 m. birželio mėn. iki 2015 m. kovo mėn. LSMUL KK atliktos superselektyvios DEB TACE procedūros naudojant doksorubicinu impregnuotas "Embozene TANDEM®" ("CeloNova", "BioScience", San Antonijus, JAV) mikrosferas. Gydymo išeitims vertinti analizuotas pacientų išgyvenamumas (mediana ir bendras išgyvenamumas), radiologinis atsakas į gydymą ir a-fetoproteino (AFP) koncentracijos pokytis lyginant reikšmes prieš pirmąjį DEB TACE ciklą ir po jo. Radiologiniam atsakui vertinti taikyti modifikuoti solidinių navikų atsako į gydymą vertinimo kriterijai (mRECIST). Išgyvenamumas vertintas taikant Kaplano ir Mejerio (Kaplan-Meier) metodą. Rezultatai. Išgyvenamumo mediana nuo diagnozės datos ir nuo pirmosios DEB TACE buvo atitinkamai 31,5 ± 9 mėn. ir 19,5 ± 3,9 mėn., bendras išgyvenamumas po 6 mėn. -100 proc. ir 93,3 proc., po 1 m. -80 proc. ir 79 proc., po 2 m. -56,1 proc. ir 29,6 proc. Objektyvus radiologinis atsakas po 1 ir 3 mėn. pasiektas atitinkamai 78,6 proc. ir 77,8 proc. AFP kon-

show abstract

Drug-eluting bead loaded with doxorubicin versus conventional Lipiodol-based transarterial chemoembolization in the treatment of hepatocellular carcinoma

Abstract: In Asian patients with HCC, transcatheter treatment with DEB loaded with doxorubicin offers a distinct advantage in objective tumor response rate as compared with conventional, Lipiodol-based TACE regimens.

Cited by 63 publications

References 20 publications

Chemoembolization for Hepatocellular Carcinoma

Chemoembolization for Hepatocellular Carcinoma

Multidisciplinary Taiwan Consensus Recommendations for the Use of DEBDOX-TACE in Hepatocellular Carcinoma Treatment

Hepatoceliulinės Karcinomos Gydymo Transarterine Chemoembolizacija Doksorubicinu Impregnuotomis Mikrosferomis (Deb Tace) Lietuvos Sveikatos Mokslų Universiteto Ligoninėje Kauno Klinikose Analizė

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