Korean Multicenter Registry of Transcatheter Arterial Chemoembolization with Drug-Eluting Embolic Agents for Nodular Hepatocellular Carcinomas: Six-Month Outcome Analysis

Lee, Myungsu; Chung, Jin Wook; Lee, Kwang-Hun; Won, Jong Yun; Chun, Ho Jong; Lee, Han Chu; Kim, Jin Hyoung; Lee, In Joon; Hur, Saebeom; Kim, Hyo Cheol; Kim, Yoon Jun; Kim, Gyoung Min; Joo, Seung Moon; Oh, Jeill

doi:10.1016/j.jvir.2016.08.017

Cited by 42 publications

(38 citation statements)

References 18 publications

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“…6,7 A recent report of a Korean multicenter registry of DEB-TACE using DC beads presented a high rate of PES (73%) after the first treatment cycle. 26 The the low incidence of PES in the DEB-TACE group in the current study might be due to the small to medium sized single HCC cohort with a small extent of involved liver. One report comparing the short-term safety and efficacy of DEB-TACE and C-TACE using the superselective TACE method showed no difference in overall toxicity between the two groups.…”

Section: Discussionmentioning

confidence: 65%

Conventional versus Drug-eluting Beads Trans-arterial Chemoembolization for Treatment of Hepatocellular Carcinoma at Very Early and Early Stages

Lee¹,

Joo²,

Yum³

et al. 2017

JLC

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Background/Aims: To retrospectively compare conventional and drug-eluting beads transarterial chemoembolization (C-TACE and DEB-TACE) for treatment of hepatocellular carcinoma (HCC) at very early and early stages. Methods:We retrospectively compared patients treated with C-TACE (n=115) or DEB-TACE (n=103) from September 2009 to May 2016. All patients were in a very early (stage 0) or early stage (stage A) of the Barcelona Clinic Liver Cancer (BCLC) staging system, and all had Child-Pugh class A and ≤B7 liver status. Approval by the institutional review board was waived because the study was retrospective. The following parameters were evaluated: severe pain and bradycardia during TACE, post-embolization syndrome (PES), liver function change, complications, target tumor response, and conversion to another treatment modality. Numeric differences were assessed by the independent Student's t-test for continuous variables and by chi-square test for categorical variables.Results: Severe intractable pain and bradycardia during the TACE procedure were significantly more frequent in the C-TACE group than in the DEB-TACE group (P<0.001). The incidence and duration of PES were significantly higher in the C-TACE group than in the DEB-TACE group (P<0.001). The increase in liver enzymes was significantly higher in the C-TACE group than in the DEB-TACE group (P<0.001). The deterioration of the Child-Pugh class was significantly higher in the C-TACE group than in the DEB-TACE group (P=0.006). There was no significant difference in serious complications except localized bile duct dilatation between the groups. There was no significant difference between the groups in tumor response at both immediate and 1-year assessment. The conversion rate to other treatment modalities was significantly higher in the DEB-TACE group than in the C-TACE group (P<0.001).Conclusions: DEB-TACE is better than C-TACE in terms of procedural safety as initial treatment in a very early or early stage of HCC. (J Liver Cancer 2017;17:144-152)

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Section: Discussionmentioning

confidence: 65%

Conventional versus Drug-eluting Beads Trans-arterial Chemoembolization for Treatment of Hepatocellular Carcinoma at Very Early and Early Stages

Lee¹,

Joo²,

Yum³

et al. 2017

JLC

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“…Infusion of 100–300-µm microspheres in an animal model of liver cancer resulted in the delivery of these microspheres intothe tumor or near its margins, justifying their use for precise drug delivery or embolization (19). Although many institutions in Korea suggest using 100–300-µm microspheres in the procedure (20), the choice of microsphere size depends on many factors, including tumor size, feeding artery diameter, personal preference and experience, and the presence or absence of an arteriovenous shunt that increases the risk of pulmonary complications (21).…”

Section: Types Of Microspheres Chemotherapeutic Drugs and Pharmacokmentioning

confidence: 99%

Update on Transarterial Chemoembolization with Drug-Eluting Microspheres for Hepatocellular Carcinoma

et al. 2019

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Conventional transcatheter arterial chemoembolization (c-TACE) is a widely used first-line palliative treatment for patients with unresectable hepatocellular carcinoma (HCC). Despite the effectiveness of c-TACE, to date, technique and procedure scheduling has not yet been standardized. Drug-eluting microspheres (DEMs) were therefore introduced to ensure more sustained and tumor-selective drug delivery for permanent embolization. These DEMs can load various drugs and release them in a sustained manner over a prolonged period. This approach ensures the delivery of high concentrations of chemotherapeutic agents to tumors, without increasing systemic concentrations, and promote tumor ischemia and necrosis. This review summarizes the recent advances in the use of DEM-TACE to treat HCC.

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“…Another trial assessed the rate of tumor necrosis after chemoembolization with epirubicin-loaded beads vs TAE with unloaded microspheres (Embosphere particles), which was pathologically proved in explanted livers of HCC patients undergoing liver transplantation: Epirubicin-loaded beads TACE showed complete necrosis in 77% of lesions, while TAE showed complete necrosis in only 27% of lesions ( P = 0.043)[29]. A recently reported prospective clinical trial of DEB-TACE in a large Korean HCC population showed an overall 6-mo survival rate was 97.4%, although more than half of patients had early stage HCC (BCLC-A, n = 77, 50.7%)[30]. Varela et al[7] firstly reported that systemic concentrations of doxorubicin were significantly lower in patients treated with DEB-TACE than patients treated with cTACE.…”

Section: Ctace Vs Deb-tace: Overall Efficacy and Safety In Intermediamentioning

confidence: 99%

“…However, regarding response to procedures, complete response rates at 1 and 6 mo were lower in HCC larger than 5 cm, compared with HCC less than 2 cm or 2-5 cm in size[30]. Moreover, in a Korean retrospective study, there was no significant difference in survival between cTACE and DBE-TACE in HCC larger than 5 cm (36.3 mo vs 33.4 mo, P = 0.702)[36].…”

Section: Controversial Issues On Ctace Vs Deb-tacementioning

confidence: 99%

Conventional vs drug-eluting beads transarterial chemoembolization for hepatocellular carcinoma

Song

Kim

2017

WJH

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Transarterial chemoembolization (TACE) is the current standard of therapy for patients with intermediate-stage hepatocellular carcinoma (HCC) according to the Barcelona Clinic Liver Cancer classification. The concept of conventional TACE (cTACE) is the selective obstruction of tumor-feeding artery by injection of chemotherapeutic agents, leading to ischemic necrosis of the target tumor via cytotoxic and ischemic effects. Drug-eluting beads (DEBs) have been imposed as novel drug-delivering agents for TACE, which allows for higher concentrations of drugs within the target tumor and lower systemic concentrations compared with cTACE. Despite the theoretical advantages of DEB-TACE, it is still controversial in clinical practice as to whether DEB-TACE is superior to cTACE in regard to overall survival and treatment response. In this review article, we summarize the clinical efficacy and safety of DEB-TACE for patients with intermediate or advanced stage HCC in comparison with cTACE.

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Korean Multicenter Registry of Transcatheter Arterial Chemoembolization with Drug-Eluting Embolic Agents for Nodular Hepatocellular Carcinomas: Six-Month Outcome Analysis

Cited by 42 publications

References 18 publications

Conventional versus Drug-eluting Beads Trans-arterial Chemoembolization for Treatment of Hepatocellular Carcinoma at Very Early and Early Stages

Conventional versus Drug-eluting Beads Trans-arterial Chemoembolization for Treatment of Hepatocellular Carcinoma at Very Early and Early Stages

Update on Transarterial Chemoembolization with Drug-Eluting Microspheres for Hepatocellular Carcinoma

Conventional vs drug-eluting beads transarterial chemoembolization for hepatocellular carcinoma

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