Five-Years Outcome Analysis of 142 Consecutive Hepatocellular Carcinoma Patients Treated with Doxorubicin Eluting Microspheres 30–60 μm: Results from a Single-Centre Prospective Phase II Trial

Malagari, Katerina; Moschouris, Hippocrates; Kiakidis, Th; Harward, Sardis; Kelekis, Alexios; Vrakas, Spiridon; Koundouras, Dimitrios; Filipiadis, D; Glantzounis, Georgios K.; Emmanouil, E; Chatziioannou, Achilleas; Vergadis, V.; Elefsiniotis, Ioannis; Koskinas, John; Dourakis, Spyros P.; Kelekis, Nikolaos

doi:10.1007/s00270-019-02260-3

Cited by 20 publications

(14 citation statements)

References 40 publications

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“…Moreover, these HepaSpheres were an effective embolic agent achieving an OR rate of 92.3% (36/39), including a CR rate of 2.6% and a PR rate of 89.7%. This OR rate was similar to or slightly higher than the OR rates of 75–100% observed in patients with HCCs > 5 cm using HepaSpheres 30–60 µm in diameter [ 4 , 24 ]. Smaller-caliber microspheres with an increased surface area may be capable of greater distal penetration and delivery of higher concentrations of chemoembolization agents [ 16 , 17 , 18 , 19 , 20 , 21 ].…”

Section: Discussionsupporting

confidence: 75%

“…Tumor response and local tumor recurrence after DEB-TACE were found to be significantly associated with large (>5 cm) tumor size [ 4 , 24 , 27 , 28 ]. Because additional treatment in patients with HCCs > 5 cm should result in a higher response rate during the follow-up period, subsequent Cis-TACE could be useful in treating these large HCCs, because most of the viable tumor after initial DEB-TACE is usually supplied by small feeding arteries or injured feeders.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, complication rates were not increased by using smaller (100–300 µm) microspheres [ 17 , 18 ]. Studies have evaluated the safety and efficacy of DEB-TACE using HepaSpheres 30–60 μm in diameter and loaded with doxorubicin [ 10 , 22 , 23 , 24 ]. The objective tumor regression rate in patients with HCCs > 5 cm using HepaSpheres 30–60 µm in diameter was 81.3% [ 10 ], much higher than the rate of 32% obtained using larger HepaSpheres (50–100 µm) [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Initial Transarterial Chemoembolization (TACE) Using HepaSpheres 20–40 µm and Subsequent Lipiodol TACE in Patients with Hepatocellular Carcinoma > 5 cm

Cho

Chu

Kim

et al. 2021

Life

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To investigate clinical outcomes of drug-eluting bead transarterial chemoembolization (DEB-TACE) using HepaSpheres 20–40 µm in diameter and subsequent cisplatin-based lipiodol TACE (Cis-TACE) in patients with hepatocellular carcinoma (HCC) > 5 cm. Materials and Methods: This study included 39 consecutive patients (34 men, 5 women; mean age, 63.5 years; range, 39–80 years) who underwent DEB-TACE using HepaSpheres 20–40 µm as first-line treatment for HCC > 5 cm (mean diameter, 8.2 cm; range, 5.1–13 cm) between September 2018 and August 2019. Patients with new tumors, residual tumors, or tumor growth after initial DEB-TACE underwent subsequent Cis-TACE. Results: All 39 patients underwent initial DEB-TACE successfully, with 35 (89.7%) and three (7.7%) patients experiencing minor and major complications, respectively. After initial DEB-TACE, one patient (2.6%) achieved complete response (CR), 35 (89.7%) achieved partial response (PR), and three (7.7%) experienced progressive disease (PD). During a median follow-up period of 14.4 months (range, 0.6–23 months), 23 patients underwent Cis-TACE, with 11, three, and nine achieving CR, PR, and PD, respectively. The median overall survival time was 20.9 months (95% confidence interval (CI), 18.6−23.2 months), the median time to progression was 8.8 months (95% CI, 6.5−11.1 months), and the median time to local tumor recurrence was 16 months (95% CI, 7.4–24.6 months). Conclusions: DEB-TACE using HepaSpheres 20–40 µm in diameter can be a safe and effective initial treatment method in patients with HCC > 5 cm. Subsequent Cis-TACE constitutes a good adjuvant method to enhance tumor response after initial DEB-TACE.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Initial Transarterial Chemoembolization (TACE) Using HepaSpheres 20–40 µm and Subsequent Lipiodol TACE in Patients with Hepatocellular Carcinoma > 5 cm

Cho

Chu

Kim

et al. 2021

Life

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“…Because of a lower post-embolization toxicity, DEB-TACE research was continued with emerging of eluting microspheres manufactured from polyvinyl alcohol (CalliSpheres, Jiangsu Hengrui), expanding trisacryl/gelatin (HepaSphere or QuadraSphere, Merit Medical), polyethylene glycol (LifePearl, Terumo), and hydrogel with polyzene coating (Tandem, Varian). All DEB-TACE beads are non-resorbable agents, permanently blocking tumor supply at different levels according to bead sizes (from 500 to 40 μ) [ 17 – 20 ]. As tumor response did not quite differ, the question remains whether the eluting chemotherapeutic or the embolic particulate dominates the anti-tumor effect.…”

mentioning

confidence: 99%

Interventional radiology for liver diseases

Defreyne

2020

Eur Radiol

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“…HepaSpheres or QuadraSphere These microspheres are hydrophilic, calibrated, and can be compressed by 80%, facilitating a smooth transit in a microcatheter. They are small, soft, and easily conform to the vessel lumen for complete occlusion, enabling greater tumor necrosis [28,29] .…”

Section: Beadmentioning

confidence: 99%

Technical update on transcatheter arterial chemoembolization

Puppala¹

2019

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Transcatheter arterial chemoembolization has become an established drug delivery system for palliative or bridging treatment of hepatocellular carcinoma. Over the last two decades, various research and developments have taken place to improve the transcatheter arterial chemoembolization procedure from both a clinical and a technical perspective. This review article aims to provide an update on the technical developments over the last decade.

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Five-Years Outcome Analysis of 142 Consecutive Hepatocellular Carcinoma Patients Treated with Doxorubicin Eluting Microspheres 30–60 μm: Results from a Single-Centre Prospective Phase II Trial

Cited by 20 publications

References 40 publications

Initial Transarterial Chemoembolization (TACE) Using HepaSpheres 20–40 µm and Subsequent Lipiodol TACE in Patients with Hepatocellular Carcinoma > 5 cm

Initial Transarterial Chemoembolization (TACE) Using HepaSpheres 20–40 µm and Subsequent Lipiodol TACE in Patients with Hepatocellular Carcinoma > 5 cm

Interventional radiology for liver diseases

Technical update on transcatheter arterial chemoembolization

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